Bassam Hannaway, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT25186 Issued in CA

Practice address

1901 W Lugonia Ave Ste 130
Redlands, CA 92374-9704

Phone

(909) 557-1600

Fax

(909) 557-1740

NPI assigned

Nov 27, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Loma Linda University School of Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

San Bernardino Medical Orthopaedic Group IncGroup PAC ID 9335045228, 92 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• San Bernardino Medical Orthopaedic Group, Inc.

  • Orthopaedic Surgery Physician
  • Redlands, CA
  • NPI 1336187475

  Physical Therapy

  Medicare reassignment Care Compare group NPD
• San Bernardino Medical Orthopaedic Group, Inc.

  • Orthopaedic Surgery Physician
  • Beaumont, CA
  • NPI 1235964537
  NPD
• Optimum Physical Therapy & Wellness

  • Physical Therapist
  • Yucaipa, CA
  • NPI 1215071485
  NPD (past)
• San Bernardino Medical Orthopaedic Group, Inc.

  • Orthopaedic Surgery Physician
  • Redlands, CA
  • NPI 1225239304
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221609600000",
    "number": "1124194618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8520",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923751720",
            "telephone_number": "909-557-1600",
            "fax_number": "909-557-1740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 W LUGONIA AVE STE 130",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923749704",
            "telephone_number": "909-557-1600",
            "fax_number": "909-557-1740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNAWAY",
        "first_name": "BASSAM",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-27",
        "last_updated": "2008-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT25186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "ZZZ29668Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hamptons Manor LLC
• Stephen Weerasit Hamra, M.D.
• Brenna Lee Hamrick-Stotts, D.D.S.
• Hanger Prosthetics & Orthotics West Inc.
• Diana Hanna, OD
• Heather A Hanning, LM,CPM
• Mark Hansen
• Staci Hansen
• John Hanson
• Kristina Hanson

• Physical Therapist in Redlands, CA
• Providers in Redlands, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.