Individual provider Active NPI

Derek M Atta, DPT

  • Orthopedic Physical Therapist
  • Aiea, HI
National Provider Identifier
1124344197
Registry record updated Nov 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
Practice address
99-115 Aiea Heights Dr Ste 253
Aiea, HI 96701-3975
Phone
(808) 773-8811
Fax
(808) 495-4418
NPI assigned
Apr 15, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X Primary

Addresses

Primary practice location

99-115 Aiea Heights Dr Ste 253
Aiea, HI 96701-3975

Mailing address

98-657 Papalealii St
Aiea, HI 96701-2755
Phone (808) 256-8395

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110118000129 HI Practitioner - Physical Therapist in Private Practice 2769671155 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atta Rehab, LLCGroup PAC ID 2062842214, 5 clinicians

Practice addresses (Care Compare)

99 -115 Aiea Heights Dr
Suite 253
Aiea, HI 96701-3975
Phone (808) 773-8811

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Atta Rehab, LLC Orthopedic CurrentSince Jan 1, 2019 Accepting new patients

Locations

99-115 Aiea Heights Dr
Ste 253
Aiea, HI 96701
Phone (808) 256-8395

Organizations & group practices 1

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": "1271289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574726400000",
    "number": "1124344197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98-657 PAPALEALII ST",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967012755",
            "telephone_number": "808-256-8395",
            "fax_number": "808-495-4418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99-115 AIEA HEIGHTS DR STE 253",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967013975",
            "telephone_number": "808-773-8811",
            "fax_number": "808-495-4418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATTA",
        "first_name": "DEREK",
        "middle_name": "M",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-15",
        "last_updated": "2019-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiea, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 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.