Bryan Joseph O'Halloran, P.T. SCS, OCS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-002907-E Issued in PA

Practice address

57 W Eagle Rd
Havertown, PA 19083-2234

Phone

(610) 789-9887

Fax

(610) 789-9883

NPI assigned

Apr 12, 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 7

Medicare fee-for-service enrollment

Enrolled in PA, NJ2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Island Physical Therapy LLC

  • Physical Therapist
  • North Wildwood, NJ
  • NPI 1710858063
  Medicare reassignment NPD Authorized official
• Pain Relief and Physical Therapy, Inc.

  • Physical Therapist
  • Havertown, PA
  • NPI 1649234923
  Medicare reassignment NPD

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277856000000",
    "number": "1295799914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 VALLEY RD",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190835434",
            "telephone_number": "610-789-1599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 W EAGLE RD",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190832234",
            "telephone_number": "610-789-9887",
            "fax_number": "610-789-9883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'HALLORAN",
        "first_name": "BRYAN",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "P.T. SCS, OCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-12",
        "last_updated": "2010-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT-002907-E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS PIN",
            "identifier": "38720",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE PROV. #",
            "identifier": "689220",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD  PIN",
            "identifier": "650015206",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE PIN",
            "identifier": "0660220000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO PROVIDER#",
            "identifier": "0959942",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONALCHOICE PROVIDER #",
            "identifier": "0660220000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA TRADITIONAL PROV. #",
            "identifier": "5245562",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jody Ann Nicosia, PT, DPT
• Erin Kathleen Nilsson, OTR/L
• Susan Noonan, CRNA
• Brenda Jean Norris, MT-BC
• Danielle Nugent, CRNP
• Gerald Francis O'Leary, MA, MT-BC, LPC
• Ann Marie O'Reilly-Gindhart, PH.D
• Ryoko Ohara, MA, LPC
• Kevin Olivo, LCSW
• On Demand Urgent Care Group, PC

• Physical Therapist in Havertown, PA
• Providers in Havertown, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2010; 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.