Bryant T Ittiara, DO is a medicare enrolled "Pain Medicine - Interventional Pain Medicine" physician in Allen Park, Michigan. He went to Lake Erie College Of Osteopathic Medicine, Erie and graduated in 2008 and has 16 years of diverse experience with area of expertise as Pain Management. He is a member of the group practice Neurological Institute Of Interventional Pain Management Pllc and his current practice location is
18707 Ecorse Rd, Allen Park, Michigan. You can reach out to his office (for appointments etc.) via phone at
(734) 682-3309.
Bryant T Ittiara is licensed to practice in Michigan (license number 5101017919) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1871829069.
Physician's Profile
Full Name | Bryant T Ittiara |
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Gender | Male |
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Speciality | Pain Management |
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Experience | 16 Years |
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Location | 18707 Ecorse Rd, Allen Park, Michigan |
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Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Bryant T Ittiara attended and graduated from Lake Erie College Of Osteopathic Medicine, Erie in 2008
NPI Data:
- NPI Number: 1871829069
- Provider Enumeration Date: 10/23/2009
- Last Update Date: 01/07/2019
Medicare PECOS Information:
- PECOS PAC ID: 3971747908
- Enrollment ID: I20131003000541
Medical Identifiers
Medical identifiers for Bryant T Ittiara such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1871829069 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207L00000X | Anesthesiology | L1593593 (Michigan) | Secondary |
207LP2900X | Anesthesiology - Pain Medicine | 5101017919 (Michigan) | Secondary |
208VP0014X | Pain Medicine - Interventional Pain Medicine | 5101017919 (Michigan) | Primary |
Medical Facilities Affiliation
Group Practice Association
Group Practice Name | Group PECOS PAC ID | No. of Members |
Neurological Institute Of Interventional Pain Management Pllc | 2163643669 | 2 |
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. Bryant T Ittiara allows following entities to bill medicare on his behalf.
Entity Name | Ambulatory Anesthesia Associates Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1952350555 PECOS PAC ID: 5092729020 Enrollment ID: O20060130000526 |
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Entity Name | Neurological Institute Of Interventional Pain Management Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1427462597 PECOS PAC ID: 2163643669 Enrollment ID: O20141027001962 |
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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. Bryant T Ittiara 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 |
Bryant T Ittiara, DO 416 James Cir, Royal Oak, MI 48067-4545 Ph: (734) 604-0017 | Bryant T Ittiara, DO 18707 Ecorse Rd, Allen Park, MI 48101-2255 Ph: (734) 682-3309 |
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