Individual provider Active NPI

Kameron T Kaneshina, DPT

  • Physical Therapist
  • Kapolei, HI
National Provider Identifier
1336604131
Registry record updated Apr 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
1001 Kamokila Blvd Ste 114
Kapolei, HI 96707-2095
Phone
(808) 674-0500
Fax
(808) 674-0511
NPI assigned
Feb 5, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X HI Primary

Addresses

Primary practice location

1001 Kamokila Blvd Ste 114
Kapolei, HI 96707-2095

Mailing address

1402 Komo Mai Dr
Pearl City, HI 96782-2244
Phone (808) 298-7401

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190422000543 HI Practitioner - Physical Therapist in Private Practice 3779825807 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stayfit Physical Therapy LLCGroup PAC ID 4486755733, 16 clinicians

Practice addresses (Care Compare)

99 -128 Aiea Heights Dr
Suite 207
Aiea, HI 96701-3968
Phone (808) 487-0487

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Stayfit Physical Therapy LLC CurrentSince Mar 2, 2019 Accepting new patients

Locations

99-128 Aiea Heights Dr
Ste 207
Aiea, HI 96701
Phone (808) 487-0487

1001 Kamokila Blvd
Ste 114
Kapolei, HI 96707
Phone (808) 674-0500

Organizations & group practices 1

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": "1549324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554940800000",
    "number": "1336604131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 KOMO MAI DR",
            "city": "PEARL CITY",
            "state": "HI",
            "postal_code": "967822244",
            "telephone_number": "808-298-7401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 KAMOKILA BLVD STE 114",
            "city": "KAPOLEI",
            "state": "HI",
            "postal_code": "967072095",
            "telephone_number": "808-674-0500",
            "fax_number": "808-674-0511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANESHINA",
        "first_name": "KAMERON",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-05",
        "last_updated": "2019-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kapolei, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2019; 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.