Active NPI
Garrett Wakato Okubo, M.S. P.T.
- Physical Therapist
- Ewa Beach, HI
National Provider Identifier
1073645545
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Feb 20, 2020.
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT-1339
- Practice address
- 91-1171 Makaaloa St
Ewa Beach, HI 96706-3929 - Phone
- (808) 258-2125
- Fax
- (808) 488-9854
- NPI assigned
- Mar 11, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT-1339 | HI | Primary |
Addresses
Primary practice location
91-1171 Makaaloa St
Ewa Beach, HI 96706-3929
Mailing address
99-611 Alia PL
Aiea, HI 96701-3330
Phone (808) 258-2125
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT-1339 | HI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Warfighter's Clinic | Past | Accepting new patients | |
| Elam Sports, Inc | Physical Therapist | Past | Accepting new patients |
| Elam Sports, Inc. | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 4
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.
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- NPI 1003357765
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1073645545",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "99-611 ALIA PL",
"city": "AIEA",
"state": "HI",
"postal_code": "967013330",
"telephone_number": "808-258-2125",
"fax_number": "808-488-9854"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "91-1171 MAKAALOA ST",
"city": "EWA BEACH",
"state": "HI",
"postal_code": "967063929",
"telephone_number": "808-258-2125",
"fax_number": "808-488-9854"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OKUBO",
"first_name": "GARRETT",
"middle_name": "WAKATO",
"credential": "M.S. P.T.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "HI",
"license": "PT-1339",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ewa Beach, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.