Individual provider Active NPI

Angela M. Peters, MPT

  • Physical Therapist
  • Kahului, HI
National Provider Identifier
1093766610
Registry record updated Oct 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2575 Issued in HI
Practice address
135 S Wakea Ave Ste 112
Kahului, HI 96732-1385
Phone
(808) 280-7711
Fax
(808) 442-0690
NPI assigned
May 16, 2006
Last updated
Oct 31, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2019

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 2575 HI Primary

Addresses

Primary practice location

135 S Wakea Ave Ste 112
Kahului, HI 96732-1385

Mailing address

PO Box 790826
Paia, HI 96779-0826
Phone (808) 280-7711

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061128000485 HI Practitioner - Physical Therapist in Private Practice 9436157526 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Utah School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

135 S Wakea Ave
Suite 112
Kahului, HI 96732-1385
Phone (808) 280-7711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2575HIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Angie Peters MPT LLC CurrentSince Feb 1, 2015 Accepting new patients
Optimal Physical Therapy,LLC Physical Therapist Past Accepting new patients
Bodies in Motion, LLC Physical Therapist PastSince Jan 1, 2011 Accepting new patients
Elite Physical Therapy and Sports Physical Therapist PastSince Jan 9, 2017 Accepting new patients

Locations

135 S Wakea Ave
Ste 113
Kahului, HI 96732

135 S Wakea Ave
Ste 112
Kahului, HI 96732
Phone (808) 280-7711

135 S Wakea Ave
Ste 112113
Kahului, HI 96732

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.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572480000000",
    "number": "1093766610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 790826",
            "city": "PAIA",
            "state": "HI",
            "postal_code": "967790826",
            "telephone_number": "808-280-7711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 S WAKEA AVE STE 112",
            "city": "KAHULUI",
            "state": "HI",
            "postal_code": "967321385",
            "telephone_number": "808-280-7711",
            "fax_number": "808-442-0690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "ANGELA",
        "middle_name": "M.",
        "name_prefix": "Mrs.",
        "credential": "MPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2019-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "2575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kahului, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2019; 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.