Individual provider Active NPI

Blake Taapai Mataoa

  • Massage Therapist
  • Hilo, HI
National Provider Identifier
1003261264
Registry record updated Apr 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
13758 Issued in HI
Practice address
465 Hinano St
Hilo, HI 96720-4406
Phone
(808) 557-9519
NPI assigned
Apr 25, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 13758 HI Primary

Addresses

Primary practice location

465 Hinano St
Hilo, HI 96720-4406

Mailing address

475 Kinoole St # 102-265
Hilo, HI 96720-2900
Phone (808) 557-9519

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
13758HIMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1461542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461542400000",
    "number": "1003261264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 KINOOLE ST # 102-265",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967202900",
            "telephone_number": "808-557-9519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 HINANO ST",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967204406",
            "telephone_number": "808-557-9519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATAOA",
        "first_name": "BLAKE",
        "middle_name": "TAAPAI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-25",
        "last_updated": "2016-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "HI",
            "license": "13758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilo, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.