Individual provider Active NPI

Randall Fukuji, PT

  • Physical Therapist
  • Honolulu, HI
National Provider Identifier
1013014919
Registry record updated Jul 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
653 Issued in HI
Practice address
1834 Nuuanu Ave Ste 101
Honolulu, HI 96817-2427
Phone
(808) 521-4922
Fax
(808) 521-4921
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 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 653 HI Primary

Addresses

Primary practice location

1834 Nuuanu Ave Ste 101
Honolulu, HI 96817-2427

Mailing address

407 Uluniu St Ste 301
Kailua, HI 96734-2544
Phone (808) 261-4321

Other identifiers 1

IdentifierTypeStateIssuer
002223MedicaidHI

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
653HIMDPhysical Therapist

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": "1373846400000",
    "number": "1013014919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 ULUNIU ST STE 301",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967342544",
            "telephone_number": "808-261-4321",
            "fax_number": "808-261-4320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1834 NUUANU AVE STE 101",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968172427",
            "telephone_number": "808-521-4922",
            "fax_number": "808-521-4921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUKUJI",
        "first_name": "RANDALL",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2013-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002223",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2013; 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.