Individual provider Active NPI

Bryar Robert Hansen, DO

  • Student in an Organized Health Care Education/Training Program
  • Brighton, MA
National Provider Identifier
1417692856
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
736 Cambridge St
Brighton, MA 02135-2907
Phone
(617) 779-6700
NPI assigned
Apr 30, 2022
Last updated
Mar 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

736 Cambridge St
Brighton, MA 02135-2907

Mailing address

736 Cambridge St
Brighton, MA 02135-2907
Phone (617) 789-2990

Other practice location 1

11 Nevins St Ste 202
Brighton, MA 02135-3514
Phone (617) 779-6700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20221121002612 MA Order and Referring Only - General SurgeryPractitioner - General Surgery 2264800358

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: bhansen259877@direct.bmc.masshiway.net

NPI Registry JSON

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

{
    "created_epoch": "1651276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1417692856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "736 CAMBRIDGE ST",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021352907",
            "telephone_number": "617-789-2990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 CAMBRIDGE ST",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021352907",
            "telephone_number": "617-779-6700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11 Nevins St Ste 202",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "MA",
            "postal_code": "021353514",
            "country_code": "US",
            "telephone_number": "617-779-6700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "BRYAR",
        "middle_name": "ROBERT",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-30",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, MA

Sources for this page

Verify at the official NPI Registry.