Individual provider Active NPI

Corey Stephen McLeod, PT, DPT

  • Physical Therapist
  • Honolulu, HI
National Provider Identifier
1174238158
Registry record updated Jan 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-5623-0 Issued in HI
Practice address
5722 Kalanianaole Hwy
Honolulu, HI 96821-2388
Phone
(808) 373-3555
Fax
(808) 373-3666
NPI assigned
Jan 13, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2023

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 PT-5623-0 HI Primary

Addresses

Primary practice location

5722 Kalanianaole Hwy
Honolulu, HI 96821-2388

Mailing address

5722 Kalanianaole Hwy
Honolulu, HI 96821-2388
Phone (808) 373-3555

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230216001552 HI Practitioner - Physical Therapist in Private Practice 2769854942 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PT Hawaii IncGroup PAC ID 6406747351, 16 clinicians

Practice addresses (Care Compare)

94-801 Farrington Hwy
Suite W2
Waipahu, HI 96797-3149
Phone (808) 680-9123

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-5623-0HIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
PT Hawaii, Inc. CurrentSince Jul 5, 2024 Accepting new patients
Orthosport Physical Therapy CurrentSince Jan 6, 2023 Accepting new patients

Locations

5722 Kalanianaole Hwy
Honolulu, HI 96821
Phone (808) 373-1114

500 Ala Moana Blvd
Ste 6D
Honolulu, HI 96813
Phone (808) 777-4000

94-801 Farrington Hwy
Ste W2
Waipahu, HI 96797

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": "1673568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1174238158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5722 KALANIANAOLE HWY",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968212388",
            "telephone_number": "808-373-3555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5722 KALANIANAOLE HWY",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968212388",
            "telephone_number": "808-373-3555",
            "fax_number": "808-373-3666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEOD",
        "first_name": "COREY",
        "middle_name": "STEPHEN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-13",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "PT-5623-0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; 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.