Individual provider Active NPI

Alexander Nathaniel Ma, DPT

  • Physical Therapist
  • Lahaina, HI
National Provider Identifier
1245959519
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-5510 Issued in HI
Practice address
40 Kupuohi St Ste 105
Lahaina, HI 96761-2714
Phone
(808) 661-0077
NPI assigned
Aug 22, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 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 Therapist 225100000X PT-5510 HI Primary

Addresses

Primary practice location

40 Kupuohi St Ste 105
Lahaina, HI 96761-2714

Mailing address

411 Huku Lii PL Ste 101
Kihei, HI 96753-7062

Other practice location 1

411 Huku Lii Pl Ste 101
Kihei, HI 96753-7062
Phone (808) 879-0077

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220906002860 HI Practitioner - Physical Therapist in Private Practice 8527442821 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Washington School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Shore Physical Therapy and Sportsmedicine, IncGroup PAC ID 5799788808, 14 clinicians

Practice addresses (Care Compare)

40 Kupuohi St
Suite 105
Lahaina, HI 96761-2714
Phone (808) 661-0077

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-5510HIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
South Shore Physical Therapy & Sportsmedicine, Inc Physical Therapist CurrentSince Sep 6, 2022 Accepting new patients
South Shore Physical Therapy & Sportsmedicine, Inc CurrentSince Sep 6, 2022 Accepting new patients

Locations

411 Huku Lii Pl
Ste 101
Kihei, HI 96753
Phone (808) 298-4933

40 Kupuohi St
Ste 105
Lahaina, HI 96761
Phone (808) 661-0077

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": "1661126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1245959519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 HUKU LII PL STE 101",
            "city": "KIHEI",
            "state": "HI",
            "postal_code": "967537062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 KUPUOHI ST STE 105",
            "city": "LAHAINA",
            "state": "HI",
            "postal_code": "967612714",
            "telephone_number": "808-661-0077"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "411 Huku Lii Pl Ste 101",
            "address_purpose": "LOCATION",
            "city": "Kihei",
            "state": "HI",
            "postal_code": "967537062",
            "country_code": "US",
            "telephone_number": "808-879-0077",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MA",
        "first_name": "ALEXANDER",
        "middle_name": "NATHANIEL",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-22",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "PT-5510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lahaina, HI

Sources for this page

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