Individual provider Active NPI

Bryan Ilar

  • Behavior Technician
  • Ewa Beach, HI
National Provider Identifier
1124883475
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
91-1087 Hoomahana St
Ewa Beach, HI 96706-4624
Phone
(808) 428-1438
NPI assigned
Feb 15, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

91-1087 Hoomahana St
Ewa Beach, HI 96706-4624

Mailing address

91-1087 Hoomahana St
Ewa Beach, HI 96706-4624
Phone (808) 428-1438

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1707955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1124883475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91-1087 HOOMAHANA ST",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967064624",
            "telephone_number": "808-428-1438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91-1087 HOOMAHANA ST",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967064624",
            "telephone_number": "808-428-1438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILAR",
        "first_name": "BRYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-15",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ewa Beach, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.