Individual provider Active NPI

Brandon Michael Trachman, PT

  • Physical Therapist
  • Kingfisher, OK
National Provider Identifier
1780883520
Registry record updated Jun 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4038 Issued in OK
Practice address
105 N Main St
Kingfisher, OK 73750-2730
Phone
(405) 375-5654
Fax
(405) 375-5655
NPI assigned
Jul 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2013

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 4038 OK Primary

Addresses

Primary practice location

105 N Main St
Kingfisher, OK 73750-2730

Mailing address

105 N Main St
Kingfisher, OK 73750-2730
Phone (405) 375-5654

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070917000096 OK Practitioner - Physical Therapist in Private Practice 0042303141 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PTMS 3.0 LLCGroup PAC ID 2365768231, 115 clinicians

Practice addresses (Care Compare)

105 N Main St
Physical Therapy Central of Kingfisher
Kingfisher, OK 73750-2730
Phone (405) 375-5654

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4038OKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
PTMS 3.0, LLC Physical Therapist CurrentSince Mar 30, 2015 Accepting new patients
PTMS 3.0, LLC Physical Therapist CurrentSince Mar 30, 2015 Accepting new patients
PTMS 3.0, LLC Physical Therapist Current Accepting new patients

Locations

105 N Main St
Kingfisher, OK 73750
Phone (405) 375-5654

3699 NW 32nd St
Newcastle, OK 73065
Phone (405) 387-5520

440 Merchant Dr
Norman, OK 73069
Phone (405) 579-1600

34637 Airline Rd
Pauls Valley, OK 73075
Phone (405) 238-7000

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": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370995200000",
    "number": "1780883520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 N MAIN ST",
            "city": "KINGFISHER",
            "state": "OK",
            "postal_code": "737502730",
            "telephone_number": "405-375-5654",
            "fax_number": "405-375-5655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 N MAIN ST",
            "city": "KINGFISHER",
            "state": "OK",
            "postal_code": "737502730",
            "telephone_number": "405-375-5654",
            "fax_number": "405-375-5655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRACHMAN",
        "first_name": "BRANDON",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-12",
        "last_updated": "2013-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "4038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingfisher, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2013; 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.