Dr Bryan Masaru Tachibana, PT, DPT, ATC, LAT is a medicare enrolled "Physical Medicine & Rehabilitation" provider in San Carlos, California. His current practice location is
301 Industrial Rd, San Carlos, California. You can reach out to his office (for appointments etc.) via phone at
(650) 632-0816.
Dr Bryan Masaru Tachibana is licensed to practice in California (license number PT299700) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1366964603.
Healthcare Provider's Profile
| Full Name | Dr Bryan Masaru Tachibana |
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| Gender | Male |
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| Speciality | Physical Medicine & Rehabilitation |
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| Location | 301 Industrial Rd, San Carlos, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1366964603
- Provider Enumeration Date: 07/07/2017
- Last Update Date: 05/27/2022
Medicare PECOS Information:
- PECOS PAC ID: 9537574652
- Enrollment ID: I20210222002737
Medical Identifiers
Medical identifiers for Dr Bryan Masaru Tachibana such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1366964603 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 225100000X | Physical Therapist | 32505 (Florida) | Secondary |
| 208100000X | Physical Medicine & Rehabilitation | PT299700 (California) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Bryan Masaru Tachibana allows following entities to bill medicare on his behalf.
| Provider Name | Agile Physical Therapy Inc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1659445443
PECOS PAC ID: 2163311556
Enrollment ID: O20040312001327 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Bryan Masaru Tachibana is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Bryan Masaru Tachibana, PT, DPT, ATC, LAT
3825 El Camino Real,
Palo Alto, CA 94306-3324
Ph: () - | Dr Bryan Masaru Tachibana, PT, DPT, ATC, LAT
301 Industrial Rd,
San Carlos, CA 94070-2603
Ph: (650) 632-0816 |
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