Individual provider Active NPI

Jonifer Fernandez Hayes, MPT

  • Physical Therapist
  • Honolulu, HI
National Provider Identifier
1073675765
Registry record updated Nov 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1803 Issued in HI
Practice address
3465 Waialae Ave Ste 240
Honolulu, HI 96816-2664
Phone
(808) 753-7617
Fax
(808) 735-3556
NPI assigned
Dec 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2021

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 1803 HI Primary

Addresses

Primary practice location

3465 Waialae Ave Ste 240
Honolulu, HI 96816-2664

Mailing address

3104 Oahu Ave
Honolulu, HI 96822-1246
Phone (808) 258-2537

Other identifiers 1

IdentifierTypeStateIssuer
506462-06MedicaidHI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051223000248 HI Practitioner - Physical Therapist in Private Practice 4880616499 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fysiotherapie Hawaii IncGroup PAC ID 7012014046, 11 clinicians

Practice addresses (Care Compare)

1120 12TH Ave
Suite 302
Honolulu, HI 96816-3790
Phone (808) 734-4043

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ptworks, LLC Physical Therapist CurrentSince Feb 2, 2009 Accepting new patients
Fysiotherapie Hawaii Inc Physical Therapist CurrentSince May 24, 2025 Accepting new patients
Breakthrough Rehab, Inc. Physical Therapist CurrentSince Dec 6, 2021 Accepting new patients
South Shore Physical Therapy, LLC Physical Therapist Past Accepting new patients

Locations

91-1121 Keaunui Dr
Ste 108155
Ewa Beach, HI 96706

3465 Waialae Ave
Ste 240
Honolulu, HI 96816
Phone (808) 753-7617

1120 12th Ave
Ste 302
Honolulu, HI 96816
Phone (808) 734-4043

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637712000000",
    "number": "1073675765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3104 OAHU AVE",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968221246",
            "telephone_number": "808-258-2537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3465 WAIALAE AVE STE 240",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968162664",
            "telephone_number": "808-753-7617",
            "fax_number": "808-735-3556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYES",
        "first_name": "JONIFER",
        "middle_name": "FERNANDEZ",
        "name_prefix": "Mrs.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-15",
        "last_updated": "2021-11-24",
        "certification_date": "2021-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "1803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "506462-06",
            "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 Nov 24, 2021; 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.