Individual provider Active NPI

Brenden Lenahan, PT

  • Physical Therapist
  • Amagansett, NY
National Provider Identifier
1710380480
Registry record updated Apr 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
037757-1 Issued in NY
Practice address
100 Montauk Hwy
Amagansett, NY 11930-2835
Phone
(631) 324-3200
Fax
(631) 324-3676
NPI assigned
Oct 8, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 037757-1 NY Primary

Addresses

Primary practice location

100 Montauk Hwy
Amagansett, NY 11930-2835

Mailing address

PO Box 2835
Amagansett, NY 11930-2835
Phone (631) 324-3200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141120000880 NY Practitioner - Physical Therapist in Private Practice 3173745577 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Erik Peterson Physical Therapy PCGroup PAC ID 0749457125, 3 clinicians
Latitude Physical TherapyGroup PAC ID 7810340296, 6 clinicians

Practice addresses (Care Compare)

100 Montauk Hwy
Amagansett, NY 11930-2835
Phone (631) 324-3200

137 Hampton Rd
Southampton, NY 11968-4923
Phone (917) 672-3319

34 Bay St
Suite 205206
Sag Harbor, NY 11963-3104
Phone (631) 919-5189

Merit-based Incentive Payment System (MIPS)

Final score
87.69 of 100Reported as group
Quality
86.29
Improvement activities
40
Cost
77.25

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
037757-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Erik Peterson Physical Therapy PC Physical Therapist CurrentSince Oct 10, 2014 Accepting new patients
Latitude Physical Therapy Physical Therapist CurrentSince Jan 1, 2026 Accepting new patients
Peterson Medical Supply Company Past Accepting new patients

Locations

34 Bay St
#205206
Sag Harbor, NY 11963
Phone (631) 919-5189

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1412726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492992000000",
    "number": "1710380480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2835",
            "city": "AMAGANSETT",
            "state": "NY",
            "postal_code": "119302835",
            "telephone_number": "631-324-3200",
            "fax_number": "631-324-3676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MONTAUK HWY",
            "city": "AMAGANSETT",
            "state": "NY",
            "postal_code": "119302835",
            "telephone_number": "631-324-3200",
            "fax_number": "631-324-3676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LENAHAN",
        "first_name": "BRENDEN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-08",
        "last_updated": "2017-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "037757-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amagansett, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2017; 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.