Individual provider Active NPI

Jessica Marie A. Ruiz, PT, DPT, LMT, GTS

  • Physical Therapist
  • Mililani, HI
National Provider Identifier
1063883866
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-6057 Issued in HI
Practice address
95-1057 Ainamakua Dr.
Suite F-11
Mililani, HI 96789
Phone
(808) 597-1005
Fax
(808) 657-3222
NPI assigned
Oct 19, 2015
Last updated
Jan 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT-6057 HI Primary
Massage Therapist 225700000X MAT-14437 HI

Addresses

Primary practice location

95-1057 Ainamakua Dr.
Suite F-11
Mililani, HI 96789

Mailing address

95-1057 Ainamakua Dr.
Suite F-11
Mililani, HI 96789
Phone (808) 597-1005

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250218003289 HI Practitioner - Physical Therapist in Private Practice 6709306913 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Institute of Physical Therapy IncGroup PAC ID 2668771999, 9 clinicians

Practice addresses (Care Compare)

98 -1005 Moanalua Rd
SPC 410
Aiea, HI 96701-4702
Phone (808) 600-9148

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MAT-14437HIMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners LLC Multi-Specialty CurrentSince Sep 22, 2025 Accepting new patients
Advanced Institute of Physical Therapy Inc Multi-Specialty CurrentSince Sep 22, 2025 Accepting new patients
Moon Physical Therapy LLC Multi-Specialty Past Accepting new patients
Anesthesia Innovations LLC Multi-Specialty PastSince Aug 2, 2021 Accepting new patients
MPT Windward LLC PastSince Jun 22, 2021 Accepting new patients
P.T. Hawaii, Inc Multi-Specialty Past Accepting new patients

Locations

98-1005 Moanalua Rd
Spc 410
Aiea, HI 96701
Phone (808) 488-5555

1401 S Beretania St
Ste 888
Honolulu, HI 96814
Phone (808) 585-8855

94-216 Farrington Hwy
#A102
Waipahu, HI 96797
Phone (808) 206-5301

Networks

  • HI PPO
  • devoted network organization-c89d4c14-e90f-4cf7-83f9-456527a52335

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DEDCCA

Organizations & group practices 6

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": "1445212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1063883866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95-1057 AINAMAKUA DR.",
            "address_2": "SUITE F-11",
            "city": "MILILANI",
            "state": "HI",
            "postal_code": "96789",
            "telephone_number": "808-597-1005",
            "fax_number": "808-657-3222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95-1057 AINAMAKUA DR.",
            "address_2": "SUITE F-11",
            "city": "MILILANI",
            "state": "HI",
            "postal_code": "96789",
            "telephone_number": "808-597-1005",
            "fax_number": "808-657-3222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "JESSICA MARIE",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, LMT, GTS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-19",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "PT-6057",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "HI",
            "license": "MAT-14437",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mililani, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 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.