Brenton Mikito Micah Kanno

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

300347 Issued in CA

Practice address

292 Reservation Rd
Marina, CA 93933-3110

Phone

(831) 883-8542

NPI assigned

Jun 24, 2021

Last updated

Jun 29, 2021By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Monterey Spine and Joint PCGroup PAC ID 0840295721, 75 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: brenton.kanno.p1@direct.msjhealth.nextgenshare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Monterey Spine & Joint PC

  • Orthopaedic Surgery Physician
  • Monterey, CA
  • NPI 1881620599
  Medicare reassignment Care Compare group NPD
• Marina Physical Therapy, Inc

  • Physical Therapy Clinic/Center
  • Marina, CA
  • NPI 1528223013

  Physical Therapist

  Medicare reassignment NPD
• Monterey Spine & Joint PC

  • Orthopaedic Surgery of the Spine Physician
  • Salinas, CA
  • NPI 1942885835
  NPD
• Montage Surgical Group

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Monterey, CA
  • NPI 1629864236
  NPD (past)

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

{
    "created_epoch": "1624492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1619546439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 GLENWOOD CIR APT 13E",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939406723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "292 RESERVATION RD",
            "city": "MARINA",
            "state": "CA",
            "postal_code": "939333110",
            "telephone_number": "831-883-8542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANNO",
        "first_name": "BRENTON",
        "middle_name": "MIKITO MICAH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-24",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "300347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosa Jones
• Vanessa L Jones, L.C.S.W.
• Daniel Juarez, BS, RBT
• Dasy Nallely Juarez
• Courtney Jundt
• Kristin Rene Kantner, MSW, LCSW
• Mohammad Karisli
• Michelle Faie Katuala
• Harleen Kaur
• Kathleen Keilman

• Physical Therapist in Marina, CA
• Providers in Marina, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; 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.