Organization Active NPI

Total Fitness Physical Therapy LLC

  • Physical Therapist
  • Honolulu, HI
National Provider Identifier
1487691838
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
857 Issued in HI
Legal business name
TOTAL FITNESS PHYSICAL THERAPY LLC
Practice address
1650 Liliha St
#107
Honolulu, HI 96817
Phone
(808) 536-6117
Fax
(808) 587-7727
NPI assigned
Jun 1, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Russell Kiyoshi Yamada, PTNPI 1407945686
Title
President
Phone
(808) 536-6117

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 857 HI Primary

Addresses

Primary practice location

1650 Liliha St
#107
Honolulu, HI 96817

Mailing address

1650 Liliha St
#107
Honolulu, HI 96817
Phone (808) 536-6117

Other identifiers 2

IdentifierTypeStateIssuer
A9315601MedicaidHI
A080760OtherHIHMSA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040322000224 HI Part B Supplier - Clinic/Group Practice 4284525213 Receives reassigned benefits from 1 practitioner
Practice locations: Honolulu, HI

National Provider Directory

National Provider Directory

Locations

1441 Kapiolani Blvd
Ste 1208
Honolulu, HI 96814
Phone (808) 536-6117

1441 Kapiolani Blvd
Ste 1412
Honolulu, HI 96814
Phone (808) 536-6117

1650 Liliha St
Ste 107
Honolulu, HI 96817
Phone (808) 398-8076

803 Kamehameha Hwy
Ste 300
Pearl City, HI 96782
Phone (808) 455-7400

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487691838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 LILIHA ST",
            "address_2": "#107",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "96817",
            "telephone_number": "808-536-6117",
            "fax_number": "808-587-7727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 LILIHA ST",
            "address_2": "#107",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "96817",
            "telephone_number": "808-536-6117",
            "fax_number": "808-587-7727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL FITNESS PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "YAMADA",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "KIYOSHI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "808-536-6117",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A9315601",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "A080760",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.