Individual provider Active NPI

Brant Barry Hafen, DO

  • Internal Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1316407828
Registry record updated Sep 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DO3209 Issued in NV
Practice address
2704 N Tenaya Way
Las Vegas, NV 89128-0424
Phone
(702) 877-5199
NPI assigned
Mar 21, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X TL000---- CO
Internal Medicine Physician 207R00000X DO3209 NV Primary

Addresses

Primary practice location

2704 N Tenaya Way
Las Vegas, NV 89128-0424

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 877-5199

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, CO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220816000786 NV Practitioner - Internal Medicine 5294065025 Reassigns benefits to 1 organization
I20260204002678 CO Practitioner - Internal Medicine 5294065025 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Alabama College of Osteopathic Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Optum Medical Group II Rhodes P CGroup PAC ID 4981687779, 296 clinicians

Practice addresses (Care Compare)

1960 N Ogden St
Denver, CO 80218-3667

2704 N Tenaya Way
Las Vegas, NV 89128-0424
Phone (702) 579-3253

8350 Colorado Blvd
Unit 160
Firestone, CO 80504-6803
Phone (303) 673-1370

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
TL000----COMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Denver, LLC CurrentSince Jan 31, 2026 Accepting new patients
Optum Medical Group Rhodes P C CurrentSince Aug 1, 2022 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Jan 31, 2026 Accepting new patients
Optum Medical Group II Rhodes P C Internal Medicine CurrentSince Aug 1, 2022 Accepting new patients
Intermountain Medical Group Denver, LLC Internal Medicine Past Accepting new patients

Locations

1960 N Ogden St
Ste 400
Denver, CO 80218
Phone (303) 318-1540

1960 N Ogden St
Ste 120
Denver, CO 80218
Phone (303) 318-3840

420 N Nellis Blvd
Las Vegas, NV 89110
Phone (702) 339-5710

2704 N Tenaya Way
Las Vegas, NV 89128
Phone (702) 243-8500

Interoperability endpoints

  • Direct secure messaging: bhafen119207@westdirect.optum.com

Organizations & group practices 5

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1553126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1316407828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-877-5199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2704 N TENAYA WAY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280424",
            "telephone_number": "702-877-5199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAFEN",
        "first_name": "BRANT",
        "middle_name": "BARRY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-21",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CO",
            "license": "TL000----",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "DO3209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.