Leda Jellum, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

4460 Issued in HI

Practice address

75 Maui Lani Elua Parkway
Wailuku, HI 96793

Phone

(808) 243-6000

NPI assigned

Sep 5, 2017

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in HI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kaiser Foundation Health Plan IncGroup PAC ID 1850205360, 107 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.

• Kaiser Foundation Health Plan Inc

  • Radiology Clinic/Center
  • Honolulu, HI
  • NPI 1063515567
  Medicare reassignment Care Compare group NPD
• Kaiser Foundation Health Plan Inc

  • Clinical Medical Laboratory
  • Wailuku, HI
  • NPI 1043227010
  NPD
• Kaiser Foundation Health Plan, Inc

  • Rural Health Clinic/Center
  • Kahuku, HI
  • NPI 1245773936
  NPD
• AMC Corporation

  • Physical Therapist
  • Kahului, HI
  • NPI 1114082625
  NPD (past)

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

{
    "created_epoch": "1504569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1346768876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 MOKUAHI ST",
            "city": "MAKAWAO",
            "state": "HI",
            "postal_code": "967688963",
            "telephone_number": "808-398-2552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 MAUI LANI ELUA PARKWAY",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "96793",
            "telephone_number": "808-243-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JELLUM",
        "first_name": "LEDA",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-05",
        "last_updated": "2021-03-18",
        "certification_date": "2020-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "4460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodhim/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Qualitycare",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "75 Maui Lani Elua Parkway",
            "city": "Wailuku",
            "state": "HI",
            "country_code": "US",
            "postal_code": "96793",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jodi Kimberly Jaslow, MA
• Jasmine Rivera
• Melody Brooks Jayne, MD
• Jeanette Evans, Inc.
• Jeffrey M Drood MD LLC
• Christina Dawn Jennings, M.S., CCC-SLP
• Kirsten Marie Jensen, NP
• Jenwei Luu MD Inc
• Joel E Ulloth, MD Inc.
• Kazue T Johansen, P.A.

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

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