Mary Therese Grageda Gomez, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

4917 Issued in HI

Practice address

95-1057 Ainamakua Dr Unit F-11
Mililani, HI 96789-6310

Phone

(808) 597-1005

NPI assigned

May 30, 2012

Sex

Female

Sole proprietor

Yes

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, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Quality Care Therapy LLCGroup PAC ID 5799798203, 9 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Quality Care Therapy, LLC

  dba Moon Physical Therapy

  • Physical Therapist
  • Honolulu, HI
  • NPI 1700816980
  Medicare reassignment Care Compare group NPD
• Moon Physical Therapy LLC

  • Physical Therapist
  • Honolulu, HI
  • NPI 1326235128
  NPD (past)

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

{
    "created_epoch": "1338336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1336400993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 HAMAKUA DR # C102",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967343984",
            "telephone_number": "808-597-1005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95-1057 AINAMAKUA DR UNIT F-11",
            "city": "MILILANI",
            "state": "HI",
            "postal_code": "967896310",
            "telephone_number": "808-597-1005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "MARY THERESE",
        "middle_name": "GRAGEDA",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-30",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "4917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Glew
• Abbygail Godbout
• Katherine K Godwin, MS OTR/L CHT
• Anthony Gogue
• Denise Gomez
• Ximena Gomez
• Gwynne Gonzales
• Miranda Gonzalez
• Myrka Gonzalez
• Wendy Gonzalez

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2023; 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.