Individual provider Active NPI

Glenn Masao Taira, D.P.T.

  • Physical Therapist
  • Waipahu, HI
National Provider Identifier
1083669469
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1713 Issued in HI
Practice address
94-1480 Moaniani St
Waipahu, HI 96797-4632
Phone
(808) 432-3186
Fax
(808) 432-3249
NPI assigned
May 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 1713 HI Primary

Addresses

Primary practice location

94-1480 Moaniani St
Waipahu, HI 96797-4632

Mailing address

98-418 Kaonohi St #1
Aiea, HI 96701
Phone (808) 226-2969

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060927000546 HI Practitioner - Physical Therapist in Private Practice 4688679566 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaiser Foundation Health Plan IncGroup PAC ID 1850205360, 107 clinicians

Practice addresses (Care Compare)

45-602 Kamehameha Hwy
Kaneohe, HI 96744-2017
Phone (808) 432-3855

599 Farrington Hwy
Kapolei, HI 96707-2028
Phone (808) 432-3668

94 -1480 Moaniani St
Waipahu, HI 96797-4632
Phone (808) 432-3177

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1713HIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan Inc CurrentSince Feb 1, 2012 Accepting new patients
Kaiser Foundation Health Plan, Inc CurrentSince Feb 1, 2012 Accepting new patients
Kaiser Foundation Health Plan Inc Current Accepting new patients

Locations

711 Kapiolani Blvd
Honolulu, HI 96813
Phone (808) 432-5312

599 Farrington Hwy
Kapolei, HI 96707
Phone (808) 432-3600

94-1480 Moaniani St
Waipahu, HI 96797
Phone (808) 432-2000

Organizations & group practices 3

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": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1083669469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98-418 KAONOHI ST #1",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "96701",
            "telephone_number": "808-226-2969",
            "fax_number": "808-432-3249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94-1480 MOANIANI ST",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967974632",
            "telephone_number": "808-432-3186",
            "fax_number": "808-432-3249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAIRA",
        "first_name": "GLENN",
        "middle_name": "MASAO",
        "name_prefix": "Mr.",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "1713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waipahu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.