Andrew Colin Fuqua

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

4640 Issued in HI

Practice address

40 Kupuohi St Ste 105
Lahaina, HI 96761-2714

Phone

(808) 661-0077

Fax

(808) 661-0177

NPI assigned

Sep 13, 2018

Sex

Male

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, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Shore Physical Therapy and Sportsmedicine, Inc 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• South Shore Physical Therapy & Sportsmedicine, Inc

  • Physical Therapy Clinic/Center
  • Kihei, HI
  • NPI 1760435218

  HI

  Medicare reassignment Care Compare group NPD
• South Shore Physical Therapy & Sportsmedicine, Inc

  • Physical Therapist
  • Kahului, HI
  • NPI 1396601647
  Care Compare group NPD

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

{
    "created_epoch": "1536796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1316420599",
    "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",
            "telephone_number": "808-879-0077",
            "fax_number": "808-879-0177"
        },
        {
            "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",
            "fax_number": "808-661-0177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUQUA",
        "first_name": "ANDREW",
        "middle_name": "COLIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-13",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "4640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samuel L Felton
• Pedro (Peter) Raul Ferrer, PT
• Kylie Flickinger
• Food Pantry, LTD
• Breanna Suzanne Fort, M.A., CCC-SLP
• Vincent Christian Fussell, MD
• Heather Galan, HEATHER GALAN
• Steven Edward Geller, PH.D.
• Darcel S. Gilbert, MD
• Gina Gillstrom, RBT

• All providers in Lahaina, HI
• Physical Therapist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2021; 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.