Bryan D Hathaway, PT

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

0116511 Issued in NY

Practice address

115 Hickories Park Rd
Owego, NY 13827-4845

Phone

(607) 687-7645

Fax

(607) 687-7646

NPI assigned

Dec 19, 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 2

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peak Performance Physical Therapy PLLCGroup PAC ID 2466483896, 3 clinicians

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.

• Peak Performance Physical Therapy PLLC

  • Physical Therapy Clinic/Center
  • Owego, NY
  • NPI 1295860765

  NY

  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1669535563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 HICKORIES PARK ROAD",
            "city": "OWEGO",
            "state": "NY",
            "postal_code": "13827",
            "telephone_number": "607-687-7645",
            "fax_number": "607-687-7646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 HICKORIES PARK RD",
            "city": "OWEGO",
            "state": "NY",
            "postal_code": "138274845",
            "telephone_number": "607-687-7645",
            "fax_number": "607-687-7646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATHAWAY",
        "first_name": "BRYAN",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "0116511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "10054748",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7357124",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Mae Harahus, LPN
• Caitlin Harding
• Nancy Grace Harrington, NP
• Bonnie Hathaway, OTR/L
• Brandon Emmett Hathaway, PT, DPT
• Hea Hea, LLC
• Louise Natalie Henley, LMSW
• Susan Hewitt, CASAC
• Anthony Charles Hill, 2-CASAC
• Jaime Hill, M.S., CCC-SLP

• All providers in Owego, NY
• Physical Medicine & Rehabilitation Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; 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.