Bryson Tanicala, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

10040 Alta Dr Ste 230
Las Vegas, NV 89145-8630

Phone

(725) 726-7847

NPI assigned

Jul 29, 2024

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 NV

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peak Condition LLCGroup PAC ID 6204885841, 6 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 Condition LLC

  • Physical Therapist
  • Las Vegas, NV
  • NPI 1205810827
  Medicare reassignment Care Compare group NPD
• Smith Therapy Partners

  • Physical Therapist
  • Las Vegas, NV
  • NPI 1134758709
  Medicare reassignment NPD
• Peak Condition, LLC

  • Physical Therapist
  • Las Vegas, NV
  • NPI 1528194610
  NPD (past)

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

{
    "created_epoch": "1722211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1700615911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8363 AURORA RIDGE AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891476238",
            "telephone_number": "808-366-2710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10040 ALTA DR STE 230",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891458630",
            "telephone_number": "725-726-7847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANICALA",
        "first_name": "BRYSON",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-29",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tangerine Psychiatry
• Tango Car, LLC
• Kristine Mei Tangonan, RN
• Raymond P. Tangredi, M.D.
• Shage Vince Maliwat Tanhueco, RN
• Taylynn Taniguchi, RBT
• Erin Nicole Tanksley, M.A., CCC-SLP
• Robert Tanksley, MA,ATR-BC
• Siohkuei Tann
• Giny Nacole Tannahill

• Physical Therapist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Physical Therapist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.