Individual provider Active NPI

Daniel Edward Rick, P.T.

  • Physical Therapist
  • Kailua Kona, HI
National Provider Identifier
1003914193
Registry record updated Feb 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-699 Issued in HI
Practice address
75-5699 Kopiko St
Kailua Kona, HI 96740-1668
Phone
(808) 329-7744
Fax
(808) 334-1608
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2008

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 PT-699 HI Primary

Addresses

Primary practice location

75-5699 Kopiko St
Kailua Kona, HI 96740-1668

Mailing address

PO Box 647
Captain Cook, HI 96704-0647
Phone (808) 323-3108

Other identifiers 5

IdentifierTypeStateIssuer
508351-01MedicaidHI
50835100OtherHIALOHA CARE
A009OtherTRICARE
B060380OtherHIHMSA 65C PLUS
217707OtherHIHMA/SUMMERLIN LIFE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120413000652 HI Practitioner - Physical Therapist in Private Practice 5991618126 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Club Rehab, Inc.Group PAC ID 0749193977, 11 clinicians

Practice addresses (Care Compare)

75 -5699 Kopiko St
Kailua Kona, HI 96740-3651
Phone (808) 329-7744

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Club Rehab, Inc. Physical Therapist CurrentSince Dec 26, 2000 Accepting new patients
Anesthesia Relief LLC Past Accepting new patients

Locations

75-5699 Kopiko St
Kailua Kona, HI 96740
Phone (808) 329-7744

73-5590 Kauhola St
Ste A
Kailua Kona, HI 96740

79-7422 Mamalahoa Hwy
Kealakekua, HI 96750
Phone (808) 322-8400

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Kona HospitalKealakekua, HI, CCN 120019 Hospital Corporate Director May 7, 2008
Kona HospitalKealakekua, HI, CCN 12S019 Hospital Corporate Director May 7, 2008
Kona HospitalKealakekua, HI, CCN 12U019 Hospital Corporate Director May 7, 2008

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203552000000",
    "number": "1003914193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 647",
            "city": "CAPTAIN COOK",
            "state": "HI",
            "postal_code": "967040647",
            "telephone_number": "808-323-3108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75-5699 KOPIKO ST",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967401668",
            "telephone_number": "808-329-7744",
            "fax_number": "808-334-1608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICK",
        "first_name": "DANIEL",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2008-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "PT-699",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "508351-01",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALOHA CARE",
            "identifier": "50835100",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "A009",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA 65C PLUS",
            "identifier": "B060380",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMA/SUMMERLIN LIFE",
            "identifier": "217707",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kailua Kona, HI

Sources for this page

Verify at the official NPI Registry.