NPIMap

Organization Active NPI

Portner Orthopedic Rehabilitation Incorporated

  • Physical Medicine & Rehabilitation Physician
  • Kaneohe, HI
National Provider Identifier
1316087315
Registry record updated Sep 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
MD-4132 Issued in HI
Legal business name
PORTNER ORTHOPEDIC REHABILITATION INCORPORATED
Practice address
45-1144 Kamehameha Hwy Ste 200
Kaneohe, HI 96744-3226
Phone
(808) 247-9408
NPI assigned
Feb 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2024

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

Authorized official

Name
Rene Noelle Mansanas
Title
Executive Vice President
Phone
(808) 379-1515

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X MD-4132 HI Primary

Addresses

Primary practice location

45-1144 Kamehameha Hwy Ste 200
Kaneohe, HI 96744-3226

Mailing address

46-001 Kamehameha Hwy Ste 109
Kaneohe, HI 96744-3724
Phone (808) 247-7596

Other practice location 1

45-1144 Kamehameha Hwy Ste 500
Kaneohe, HI 96744-3226
Phone (808) 247-9408

Other identifiers 1

IdentifierTypeStateIssuer
HPOROtherHIPTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040520000713 HI Part B Supplier - Clinic/Group Practice 7214928092 Receives reassigned benefits from 9 practitioners
Practice locations: Kaneohe, HI

National Provider Directory

National Provider Directory

Locations

45-1144 Kamehameha Hwy
Ste 306
Kaneohe, HI 96744

Practitioners & affiliated clinicians

Practitioners 49

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 49

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725580800000",
    "number": "1316087315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46-001 KAMEHAMEHA HWY STE 109",
            "city": "KANEOHE",
            "state": "HI",
            "postal_code": "967443724",
            "telephone_number": "808-247-7596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45-1144 KAMEHAMEHA HWY STE 200",
            "city": "KANEOHE",
            "state": "HI",
            "postal_code": "967443226",
            "telephone_number": "808-247-9408"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "45-1144 Kamehameha Hwy Ste 500",
            "address_purpose": "LOCATION",
            "city": "Kaneohe",
            "state": "HI",
            "postal_code": "967443226",
            "country_code": "US",
            "telephone_number": "808-247-9408",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PORTNER ORTHOPEDIC REHABILITATION INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A",
        "authorized_official_last_name": "MANSANAS",
        "authorized_official_first_name": "RENE",
        "authorized_official_middle_name": "NOELLE",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "808-379-1515"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "HI",
            "license": "MD-4132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "HPOR",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kaneohe, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2024; 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.