Active NPI
Brent Ryo Hisaka, PT, DPT
- Physical Therapist
- Oakland, CA
National Provider Identifier
1235778499
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT297227
- Practice address
- 744 52ND St
Oakland, CA 94609-1810 - Phone
- (510) 428-3558
- NPI assigned
- Jan 4, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT297227 | CA | Primary |
Addresses
Primary practice location
744 52ND St
Oakland, CA 94609-1810
Mailing address
4421 Weeping Spruce CT
Concord, CA 94521-4442
Phone (925) 348-7783
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT297227 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1578096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578096000000",
"number": "1235778499",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4421 WEEPING SPRUCE CT",
"city": "CONCORD",
"state": "CA",
"postal_code": "945214442",
"telephone_number": "925-348-7783"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "744 52ND ST",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946091810",
"telephone_number": "510-428-3558"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HISAKA",
"first_name": "BRENT",
"middle_name": "RYO",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-01-04",
"last_updated": "2020-01-04",
"certification_date": "2020-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT297227",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.