NPIMap

Individual provider Active NPI

Bryan Le Holand, DPM

  • Foot & Ankle Surgery Podiatrist
  • Bellevue, WA
National Provider Identifier
1699139055
Registry record updated Feb 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO61064740 Issued in WA
Practice address
4140 Factoria Blvd SE Ste 1B
Bellevue, WA 98006-5261
Phone
(425) 644-2313
NPI assigned
Apr 11, 2016
Last updated
Feb 4, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X PO61064740 WA Primary

Addresses

Primary practice location

4140 Factoria Blvd SE Ste 1B
Bellevue, WA 98006-5261

Mailing address

4140 Factoria Blvd SE Ste 1B
Bellevue, WA 98006-5261

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210609001374 WA Practitioner - Podiatry 9032455977 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
R Franklin University of Med & Sci/Chicago Medical School, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

751 NE Blakely Dr
Issaquah, WA 98029-6201
Phone (425) 313-4000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue76
Removal of skin lesions1-10
Removal of nail tissue187
Removal or shaving of skin growth144
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO61064740WAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mill Creek Foot & Ankle Clinic P.C. Foot & Ankle Surgery CurrentSince May 12, 2021 Accepting new patients
Ankle & Foot Specialists of Puget Sound, PS Foot & Ankle Surgery Current Accepting new patients
Ankle & Foot Specialist of Puget Sound, PS CurrentSince Mar 1, 2022 Accepting new patients
Ankle & Foot Specialists of Puget Sound, PS Foot & Ankle Surgery CurrentSince Mar 1, 2022 Accepting new patients
Ankle & Foot Specialists of Puget Sound, PS Foot & Ankle Surgery Past Accepting new patients
Hansen Foot and Ankle LLC Foot & Ankle Surgery PastSince May 12, 2021 Accepting new patients

Locations

4140 Factoria Blvd SE
Ste 1B
Bellevue, WA 98006
Phone (425) 644-2313

751 NE Blakely Dr
Issaquah, WA 98029
Phone (425) 313-4000

16708 Bothell Hwy
Ste 204
Mill Creek, WA 98012
Phone (425) 482-6663

2728 E Main
Ste A
Puyallup, WA 98372
Phone (253) 841-2006

Interoperability endpoints

  • Direct secure messaging: bholand@aafsopsp-wa.direct.office.nextgen.com
  • FHIR API: https://api.platform.athenahealth.com/26643/brand/1/csg/1/fhir/r4

Organizations & group practices 6

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1460332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1699139055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 FACTORIA BLVD SE STE 1B",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980065261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4140 FACTORIA BLVD SE STE 1B",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980065261",
            "telephone_number": "425-644-2313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLAND",
        "first_name": "BRYAN",
        "middle_name": "LE",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-11",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "WA",
            "license": "PO61064740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.