Active NPI
Brynn Hathaway, MD
- Orthopaedic Surgery Physician
- Philadelphia, PA
National Provider Identifier
1740740786
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- MD495166
- Practice address
- 3401 Civic Center Blvd
Philadelphia, PA 19104-4319 - Phone
- (208) 777-8905
- NPI assigned
- Mar 25, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | MD495166 | PA | Primary |
Addresses
Primary practice location
3401 Civic Center Blvd
Philadelphia, PA 19104-4319
Mailing address
2929 Arch St FL 12
Philadelphia, PA 19104-2857
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190426001608 | OR | Order and Referring Only - Plastic and Reconstructive Surgery | 8628310430 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785801600000",
"number": "1740740786",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2929 ARCH ST FL 12",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191042857"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3401 CIVIC CENTER BLVD",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191044319",
"telephone_number": "208-777-8905"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HATHAWAY",
"first_name": "BRYNN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-25",
"last_updated": "2026-08-04",
"certification_date": "2026-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "PA",
"license": "MD495166",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.