Individual provider Active NPI

Jacquelyn Victoria Vaughan Reiser, D.P.T.

  • Orthopedic Physical Therapist
  • Haleiwa, HI
National Provider Identifier
1336586106
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
3797 Issued in HI
Practice address
66-210 Kamehameha Hwy Ste a
Haleiwa, HI 96712-2408
Phone
(808) 726-3837
Fax
(808) 427-5174
NPI assigned
Jun 3, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305207975 VA
Orthopedic Physical Therapist 2251X0800X 3797 HI Primary

Addresses

Primary practice location

66-210 Kamehameha Hwy Ste a
Haleiwa, HI 96712-2408

Mailing address

66-210 Kamehameha Hwy Ste a
Haleiwa, HI 96712-2408
Phone (808) 726-3837

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190220002196 HI Practitioner - Physical Therapist in Private Practice 8729365523 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kuleana Physical Therapy and WellnessGroup PAC ID 6901277151, 3 clinicians

Practice addresses (Care Compare)

66-210 Kamehameha Hwy
Suite a
Haleiwa, HI 96712-2408
Phone (808) 726-3837

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3797HIMDInternal Medicine Physician
2305207975VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kuleana Physical Therapy and Wellness Physical Therapist CurrentSince Dec 19, 2022 Accepting new patients
Haleiwa Physical Therapy LLC Physical Therapist CurrentSince Feb 1, 2019 Accepting new patients
DRS. Clarence Y. Murata & Ken Nagahiro CurrentSince Dec 19, 2022 Accepting new patients

Locations

66-210 Kamehameha Hwy
Ste A
Haleiwa, HI 96712
Phone (808) 637-5048

66-590 Kamehameha Hwy
Ste 2F
Haleiwa, HI 96712
Phone (808) 260-7210

66-590 Kamehameha Hwy
Ste 2F
Haleiwa, HI 96712
Phone (205) 572-1487

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1370217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1336586106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66-210 KAMEHAMEHA HWY STE A",
            "city": "HALEIWA",
            "state": "HI",
            "postal_code": "967122408",
            "telephone_number": "808-726-3837",
            "fax_number": "808-427-5174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66-210 KAMEHAMEHA HWY STE A",
            "city": "HALEIWA",
            "state": "HI",
            "postal_code": "967122408",
            "telephone_number": "808-726-3837",
            "fax_number": "808-427-5174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISER",
        "first_name": "JACQUELYN",
        "middle_name": "VICTORIA VAUGHAN",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-03",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305207975",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "HI",
            "license": "3797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Haleiwa, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2025; 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.