Tanya L Raymond, PT, LMT
Individual provider Active NPI Physical Therapist · Paia, HI
NPI 1194769174 · NPPES record last updated Mar 15, 2017
Key facts
- NPI
- 1194769174
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT583 (HI)
- Practice address
- 36 Kaulua PL
Paia, HI 96779-9719 - Phone
- (808) 351-4322
- Fax
- (808) 757-9391
- NPI assigned
- Jun 16, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1982
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
36 Kaulua PL
Paia, HI 96779-9719
Phone (808) 351-4322
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in HI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070910000798 | HI | Practitioner - Physical Therapist in Private Practice | 6002909868 | Practice locations: Paia, HI |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 583 | HI | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 583 | HI | |
| Physical Therapist | 225100000X | PT583 | HI | Yes |
Addresses
Primary practice location
36 Kaulua PL
Paia, HI 96779-9719
Mailing address
36 Kaulua PL
Paia, HI 96779-9719
Phone (808) 351-4322
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 07058601 | Medicaid | HI | |
| 00M0091779 | Other | HI | HMSA |
| M09177-9 | Other | HI | HMSA |
Other providers in Paia, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 15, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.