Individual provider Active NPI

Jonathan Mead Raymond, MSPT

  • Physical Therapist
  • Makawao, HI
National Provider Identifier
1023095890
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5707 Issued in HI
Practice address
40 Kupaoa St # B-201
Makawao, HI 96768-6215
Phone
(808) 872-0077
Fax
(808) 872-0177
NPI assigned
Dec 22, 2005
Last updated
Jan 28, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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 5707 HI Primary

Addresses

Primary practice location

40 Kupaoa St # B-201
Makawao, HI 96768-6215

Mailing address

411 Huku Lii PL Ste 101
Kihei, HI 96753-7062
Phone (808) 879-0077

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, HI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040601000742 MA Practitioner - Physical Therapist in Private Practice 8527040914 Reassigns benefits to 1 organization
I20230831003325 HI Practitioner - Physical Therapist in Private Practice 8527040914 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trustees of Boston UniversityGroup PAC ID 8921070822, 43 clinicians

Practice addresses (Care Compare)

915 Commonwealth Ave
Boston, MA 02215-1394
Phone (617) 358-3700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5707HIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
South Shore Physical Therapy & Sportsmedicine, Inc Physical Therapist CurrentSince Jan 21, 2025 Accepting new patients
Darrin Huth Inc. Physical Therapist CurrentSince Aug 21, 2023 Accepting new patients
South Shore Physical Therapy & Sportsmedicine, Inc CurrentSince Jan 21, 2025 Accepting new patients
Physical Therapy at Pukalani, LLC Physical Therapist CurrentSince Aug 21, 2023 Accepting new patients
Bay State Physical Therapy of Randolph Inc Physical Therapist Past Accepting new patients
Burlington Physical Therapy, PC, Dba Orthopaedics Plus Physical Therapist Past Accepting new patients
Burlington Physical Therapy, PC Dba Orthopaedics Plus Physical Therapist Past Accepting new patients
Peak Performance Orthopedic Physical Therapy PC Physical Therapist PastSince Dec 1, 2001 Accepting new patients

Locations

118 Maa St
Kahului, HI 96732
Phone (808) 244-0077

411 Huku Lii Pl
Ste 101
Kihei, HI 96753
Phone (808) 298-4933

40 Kupuohi St
Ste 105
Lahaina, HI 96761
Phone (808) 661-0077

40 Kupaoa St
#B201
Makawao, HI 96768
Phone (808) 872-0077

81 Makawao Ave
Ste 110
Makawao, HI 96768
Phone (808) 572-2281

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1023095890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 HUKU LII PL STE 101",
            "city": "KIHEI",
            "state": "HI",
            "postal_code": "967537062",
            "telephone_number": "808-879-0077",
            "fax_number": "808-879-0177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 KUPAOA ST # B-201",
            "city": "MAKAWAO",
            "state": "HI",
            "postal_code": "967686215",
            "telephone_number": "808-872-0077",
            "fax_number": "808-872-0177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYMOND",
        "first_name": "JONATHAN",
        "middle_name": "MEAD",
        "name_prefix": "Mr.",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "5707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Makawao, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.