Active NPI
Lauren Lacerdo
- Physical Medicine & Rehabilitation Physician
- Kailua, HI
National Provider Identifier
1154843415
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- PT-4415
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT-4415 | HI | MD | Physical Medicine & Rehabilitation Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hana Pono Wellness Center LLC | Current | Accepting new patients | |
| Fukuji & Lum Physical Therapy Associates Inc. | Current | 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.