Amedeo Daniel Ezzo-White Sr.

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA-178 Issued in HI

Practice address

194 Kilauea Ave Apt 102
Hilo, HI 96720-2990

Phone

(808) 935-5255

NPI assigned

Aug 9, 2024

Last updated

Aug 9, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Pakolea LLC

  dba Big Island Physical Therapy

  • Rehabilitation Clinic/Center
  • Hilo, HI
  • NPI 1629309331
  NPD

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

{
    "created_epoch": "1723161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1083445225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "194 KILAUEA AVE APT 102",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967202990",
            "telephone_number": "808-935-5255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "194 KILAUEA AVE APT 102",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967202990",
            "telephone_number": "808-935-5255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZZO-WHITE",
        "first_name": "AMEDEO",
        "middle_name": "DANIEL",
        "name_suffix": "Sr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-09",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "HI",
            "license": "PTA-178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ken Everly, PHARMD
• Eye Q Hawaii, LLC (Caron K Fernandez, OD)
• Eyeland Eyedoc LLC
• Eyewear Hawaii, Inc.
• Eyewear Hilo, LLC
• Cynthia Fata, M.A.
• Joshua Fay
• Barbara Feliciano, LCSW
• Macintyre Felton
• Caron K Fernandez, OD

• Physical Therapy Assistant in Hilo, HI
• Providers in Hilo, HI by specialty
• Physical Therapy Assistant in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2024; 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.