Talia Petersen, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5509 Issued in HI

Practice address

101 Kanani Rd
Kihei, HI 96753-6805

Phone

(808) 633-4480

NPI assigned

Aug 11, 2022

Last updated

Aug 11, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in HI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Venture Physical Therapy LLCGroup PAC ID 6901961861, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Venture Physical Therapy LLC

  • Physical Therapist
  • Kihei, HI
  • NPI 1093960171
  Medicare reassignment Care Compare group NPD
• Venture Physical Therapy LLC

  • Physical Therapist
  • Lanai City, HI
  • NPI 1922589316
  NPD

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

{
    "created_epoch": "1660176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1306574884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "977 SLATE DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954055592",
            "telephone_number": "707-280-4533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 KANANI RD",
            "city": "KIHEI",
            "state": "HI",
            "postal_code": "967536805",
            "telephone_number": "808-633-4480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "TALIA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-11",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "5509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Lee Parent
• McKenzie Parker
• Paul Parsons, LMT
• Jessica Marla Pearl-Kwon, RBT
• Andrea Pekelo, RBT
• Leif Eric Peterson, MT
• Pharmacy Corporation of America (Kihei Professional Pharmacy)
• Physical Therapy Homecare
• Donalyn Tavara Piano
• Richard Pinner, DC

• Physical Therapist in Kihei, HI
• Providers in Kihei, HI by specialty
• Physical Therapist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.