Individual provider Active NPI

Lauren Lacerdo

  • Physical Medicine & Rehabilitation Physician
  • Kailua, HI
National Provider Identifier
1154843415
Registry record updated Dec 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
PT-4415 Issued in HI
Practice address
2 Aarona PL Ste 202
Kailua, HI 96734-2545
Phone
(808) 263-4343
Fax
(808) 263-4241
NPI assigned
Jul 7, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X PT-4415 HI Primary

Addresses

Primary practice location

2 Aarona PL Ste 202
Kailua, HI 96734-2545

Mailing address

2 Aarona PL Ste 202
Kailua, HI 96734-2545
Phone (808) 263-4343

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171113003612 HI Practitioner - Physical Therapist in Private Practice 1153687835 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hana Pono Wellness Center LLCGroup PAC ID 2365864337, 11 clinicians

Practice addresses (Care Compare)

2 Aarona PL
Suite 202
Kailua, HI 96734-2545
Phone (808) 263-4343

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-4415HIMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hana Pono Wellness Center LLC CurrentSince Feb 7, 2022 Accepting new patients
Fukuji & Lum Physical Therapy Associates Inc. CurrentSince Sep 1, 2017 Accepting new patients

Locations

2 Aarona Pl
Ste 202
Kailua, HI 96734
Phone (808) 263-4343

407 Uluniu St
Ste 301
Kailua, HI 96734
Phone (808) 261-4321

Organizations & group practices 2

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": "1499385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671667200000",
    "number": "1154843415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 AARONA PL STE 202",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967342545",
            "telephone_number": "808-263-4343",
            "fax_number": "808-263-4241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 AARONA PL STE 202",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967342545",
            "telephone_number": "808-263-4343",
            "fax_number": "808-263-4241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACERDO",
        "first_name": "LAUREN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-07",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "HI",
            "license": "PT-4415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kailua, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.