Individual provider Active NPI

Faith A Dandeneau, PT

  • Physical Therapist
  • Kapolei, HI
National Provider Identifier
1538308697
Registry record updated Mar 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2792 Issued in HI
Practice address
599 Farrington Hwy Ste 208
Kapolei, HI 96707-2028
Phone
(808) 674-1142
NPI assigned
Feb 13, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2021

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 2792 HI Primary

Addresses

Primary practice location

599 Farrington Hwy Ste 208
Kapolei, HI 96707-2028

Mailing address

524 Harton Cir
Virginia Beach, VA 23452-3504
Phone (713) 899-7770

Other practice location 1

397 Little Neck Rd Ste 100
Virginia Beach, VA 23452-5764
Phone (808) 778-2227

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210310002347 VA Practitioner - Physical Therapist in Private Practice 7810045598 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pt2Go LLC 6 clinicians

Practice addresses (Care Compare)

752 Southleaf Dr
Virginia Beach, VA 23462-4749
Phone (757) 222-2230

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2792HIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Vim LLC Physical Therapist CurrentSince Dec 3, 2023 Accepting new patients
PT Hawaii, Inc. PastSince Oct 22, 2009 Accepting new patients

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": "1234483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615248000000",
    "number": "1538308697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "524 HARTON CIR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234523504",
            "telephone_number": "713-899-7770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "599 FARRINGTON HWY STE 208",
            "city": "KAPOLEI",
            "state": "HI",
            "postal_code": "967072028",
            "telephone_number": "808-674-1142"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "397 Little Neck Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234525764",
            "country_code": "US",
            "telephone_number": "808-778-2227",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DANDENEAU",
        "first_name": "FAITH",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-13",
        "last_updated": "2021-03-09",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "2792",
            "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 Mar 9, 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.