Individual provider Active NPI

Thomas Hie-Lar Tan, PT

  • Physical Therapist
  • Waipahu, HI
National Provider Identifier
1114089497
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
936 Issued in HI
Practice address
94-370 Pupupani St
Waipahu, HI 96797-2657
Phone
(808) 676-7700
Fax
(808) 676-7708
NPI assigned
Dec 14, 2006
Last updated
Aug 16, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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 936 HI Primary

Addresses

Primary practice location

94-370 Pupupani St
Waipahu, HI 96797-2657

Mailing address

94-370 Pupupani St
Waipahu, HI 96797-2657
Phone (808) 676-7700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070809000156 HI Practitioner - Physical Therapist in Private Practice 4789574005 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wahiawa Rehab Services IncGroup PAC ID 5496646283, 6 clinicians
Waianae Valley Physical Therapy IncGroup PAC ID 1355231770, 6 clinicians
Waipahu Physical Therapy IncGroup PAC ID 5597656694, 4 clinicians

Practice addresses (Care Compare)

735 California Ave
Wahiawa, HI 96786-1935
Phone (808) 628-9988

85-885 Farrington Hwy
Waianae, HI 96792-2440
Phone (808) 696-4964

94 -370 Pupupani St
Waipahu, HI 96797-2657
Phone (808) 676-7700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
936HIMDChiropractor

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, 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": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1114089497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94-370 PUPUPANI ST",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967972657",
            "telephone_number": "808-676-7700",
            "fax_number": "808-676-7708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94-370 PUPUPANI ST",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967972657",
            "telephone_number": "808-676-7700",
            "fax_number": "808-676-7708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "THOMAS",
        "middle_name": "HIE-LAR",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "936",
            "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 Aug 16, 2022; 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.