Individual provider Active NPI

Amanda Marie Gelsomino, P.T.

  • Physical Therapist
  • Kailua Kona, HI
National Provider Identifier
1427344050
Registry record updated Jun 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-3386 Issued in HI
Practice address
75-165 Hualalai Rd
Kailua Kona, HI 96740
Phone
(808) 329-0591
Fax
(808) 329-2066
NPI assigned
Jun 22, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2011

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 PT-3386 HI Primary

Addresses

Primary practice location

75-165 Hualalai Rd
Kailua Kona, HI 96740

Mailing address

75-165 Hualalai Rd
Kailua Kona, HI 96740
Phone (808) 329-0591

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-3386HIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hawaiian Rehabilitation Services Inc Physical Therapist PastSince Apr 1, 2010 Accepting new patients

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": "1308700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308700800000",
    "number": "1427344050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75-165 HUALALAI RD",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "96740",
            "telephone_number": "808-329-0591",
            "fax_number": "808-329-2066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75-165 HUALALAI RD",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "96740",
            "telephone_number": "808-329-0591",
            "fax_number": "808-329-2066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GELSOMINO",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-22",
        "last_updated": "2011-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "PT-3386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kailua Kona, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.