Individual provider Active NPI

Brandon M Green, DPT

  • Physical Therapist
  • Hyannis, MA
National Provider Identifier
1609605336
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
27728 Issued in MA
Practice address
130 North St Ste C
Hyannis, MA 02601-3825
Phone
(508) 771-6685
Fax
(508) 771-5774
NPI assigned
Jul 31, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 27728 MA Primary

Addresses

Primary practice location

130 North St Ste C
Hyannis, MA 02601-3825

Mailing address

130 North St Ste C
Hyannis, MA 02601-3825
Phone (508) 771-6685

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240813001307 MA Practitioner - Physical Therapist in Private Practice 6800334590 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cape Cod Orthopedics and Sports Medicine PCGroup PAC ID 0446225205, 33 clinicians

Practice addresses (Care Compare)

130 N St
Hyannis, MA 02601
Phone (508) 775-8282

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27728MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cape Cod Orthopedics and Sports Medicine PC Physical Therapist CurrentSince Jul 6, 2024 Accepting new patients
Cape Cod Orthopedics and Sports Medicine PC CurrentSince Jul 6, 2024 Accepting new patients

Locations

130 North St
Ste A
Hyannis, MA 02601
Phone (508) 775-8282

130 North St
Hyannis, MA 02601
Phone (508) 775-8282

130 North St
Ste C
Hyannis, MA 02601
Phone (508) 771-6685

18 Route 6A
Apt 2
Sandwich, MA 02563
Phone (508) 771-4691

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1722384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1609605336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 NORTH ST STE C",
            "city": "HYANNIS",
            "state": "MA",
            "postal_code": "026013825",
            "telephone_number": "508-771-6685",
            "fax_number": "508-771-5774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 NORTH ST STE C",
            "city": "HYANNIS",
            "state": "MA",
            "postal_code": "026013825",
            "telephone_number": "508-771-6685",
            "fax_number": "508-771-5774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "BRANDON",
        "middle_name": "M",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-31",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "27728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyannis, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; 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.