Bryant Hansen, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA-1148 Issued in ID

Practice address

72 S 1St E Ste 101
Rexburg, ID 83440-1965

Phone

(208) 356-4900

Fax

(208) 356-3724

NPI assigned

Feb 24, 2014

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 ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Upper Valley Community Health Services IncGroup PAC ID 4385725282, 31 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Madison Memorial Hospital Hospital, Rexburg, ID, CCN 130025

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: hansenbr@direct.madisonmemorial.org

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.

• Upper Valley Community Health Services Inc

  • Federally Qualified Health Center (FQHC)
  • Saint Anthony, ID
  • NPI 1972792489
  Medicare reassignment Care Compare group NPD (past)
• Madison Co Memorial Hospital

  • General Acute Care Hospital
  • Rexburg, ID
  • NPI 1992747570
  NPD
• Upper Valley Community Health Services Inc

  • Federally Qualified Health Center (FQHC)
  • Idaho Falls, ID
  • NPI 1205698099
  NPD
• Upper Valley Community Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Dubois, ID
  • NPI 1649142712
  NPD
• Upper Valley Community Health Services Inc

  • Federally Qualified Health Center (FQHC)
  • Rexburg, ID
  • NPI 1124403258
  NPD (past)
• Upper Valley Community Health Services Inc

  • Federally Qualified Health Center (FQHC)
  • Idaho Falls, ID
  • NPI 1932961810
  NPD (past)

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

• Madison Co Memorial Hospital

  • Obstetrics & Gynecology Physician
  • Rexburg, ID
  • NPI 1073154266

  Hospital

  Care Compare affiliation
• Madison Co Memorial Hospital

  • General Acute Care Hospital
  • Rexburg, ID
  • NPI 1992747570
  Care Compare affiliation

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

{
    "created_epoch": "1393200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1669897989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18",
            "city": "SAINT ANTHONY",
            "state": "ID",
            "postal_code": "834450018",
            "telephone_number": "208-356-4900",
            "fax_number": "208-624-4112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 S 1ST E STE 101",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834401965",
            "telephone_number": "208-356-4900",
            "fax_number": "208-356-3724"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "335 E Main St Ste 1",
            "address_purpose": "LOCATION",
            "city": "Saint Anthony",
            "state": "ID",
            "postal_code": "834451546",
            "country_code": "US",
            "telephone_number": "208-356-4900",
            "fax_number": "208-624-4116",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "450 E Main St",
            "address_purpose": "LOCATION",
            "city": "Rexburg",
            "state": "ID",
            "postal_code": "834402048",
            "country_code": "US",
            "telephone_number": "208-356-3691",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "BRYANT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-24",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-1148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maiya Hammer, PTA
• Ronald John Hammond, D.D.S.
• Victoria Hammond
• Jeffrey D Hancock, MD
• Nathan Chad Hancock, MD
• David Victor Hansen, M.D.
• Dwayne M Hansen, M.D.
• Dwayne Maxwell Hansen Jr., DO
• Hanson Group LLC
• Douglass Eugene Hanson, OPTOMETRIST

• Physician Assistant in Rexburg, ID
• Providers in Rexburg, ID by specialty
• Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.