Individual provider Active NPI

Brenden Lewer, PT, DPT

  • Physical Therapist
  • Hana, HI
National Provider Identifier
1679777924
Registry record updated Feb 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-5651 Issued in HI
Practice address
4590 Hana Hwy
Hana, HI 96713
Phone
(808) 248-8294
NPI assigned
Jun 12, 2007
Last updated
Feb 15, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X LPT-009705 AZ
Physical Therapist 225100000X PT-5651 HI Primary
Physical Therapist 225100000X 070-014831 IL

Addresses

Primary practice location

4590 Hana Hwy
Hana, HI 96713

Mailing address

4590 Hana Hwy
Hana, HI 96713

Other practice location 1

12315 N Vistoso Park Rd
Oro Valley, AZ 85755-5819
Phone (520) 544-9700

Other identifiers 2

IdentifierTypeStateIssuer
252398MedicaidAZ
006438MedicaidHI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230517003177 HI Practitioner - Physical Therapist in Private Practice 2769574979 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hana HealthGroup PAC ID 0749192920, 15 clinicians

Practice addresses (Care Compare)

4590 Hana Hwy
Hana, HI 96713
Phone (808) 248-8294

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9705AZMDFamily Medicine Physician
LPT-009705AZMDPhysical Therapist
070-014831ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hana Health CurrentSince Mar 1, 2023 Accepting new patients
Hana Health Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: brenden.lewer.1@9596.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/9596/brand/1/csg/1/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1679777924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4590 HANA HWY",
            "city": "HANA",
            "state": "HI",
            "postal_code": "96713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4590 HANA HWY",
            "city": "HANA",
            "state": "HI",
            "postal_code": "96713",
            "telephone_number": "808-248-8294"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12315 N Vistoso Park Rd",
            "address_purpose": "LOCATION",
            "city": "Oro Valley",
            "state": "AZ",
            "postal_code": "857555819",
            "country_code": "US",
            "telephone_number": "520-544-9700",
            "fax_number": "520-618-6060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWER",
        "first_name": "BRENDEN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-12",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-009705",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "PT-5651",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-014831",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "252398",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006438",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hana, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 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.