Proximal Physical Therapy and Wellness LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

PROXIMAL PHYSICAL THERAPY AND WELLNESS LLC

Practice address

15-2984 Pahoa Village Rd
Pahoa, HI 96778

Phone

(808) 796-3310

Fax

(808) 796-3309

NPI assigned

Oct 5, 2021

Organization subpart

No

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

Authorized official

Name

Marc Saguiguit, PT

Title

Staff PT

Phone

(808) 796-3310

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Proximal Physical Therapy and Wellness LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in HI

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marc Jayson Nalundasan Saguiguit, PT

  • Physical Therapist
  • Pahoa, HI
  • NPI 1770940413
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1633392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633392000000",
    "number": "1285306589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 492907",
            "city": "KEAAU",
            "state": "HI",
            "postal_code": "967492907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15-2984 PAHOA VILLAGE RD",
            "city": "PAHOA",
            "state": "HI",
            "postal_code": "96778",
            "telephone_number": "808-796-3310",
            "fax_number": "808-796-3309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROXIMAL PHYSICAL THERAPY AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-05",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-01",
        "status": "A",
        "authorized_official_last_name": "SAGUIGUIT",
        "authorized_official_first_name": "MARC",
        "authorized_official_title_or_position": "STAFF PT",
        "authorized_official_telephone_number": "808-796-3310",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1770940413",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Proximal Physical Therapy and Wellness LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Isabel Quarta, BSC
• Michael Henry Quay, MHC

• Physical Therapy Clinic/Center in Pahoa, HI
• Providers in Pahoa, HI by specialty
• Physical Therapy Clinic/Center in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.