Malia Pua Lokelani Tallett, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

3170 Issued in HI

Practice address

2064 Kilauea Ave
Hilo, HI 96720-5233

Phone

(808) 339-7478

Fax

(808) 657-4980

NPI assigned

Dec 18, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Mrs. Malia Pua Lokelani Pruett Former name

Medicare fee-for-service enrollment

Enrolled in HI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ke Ola Kino Physical Therapy, LLCGroup PAC ID 4183970460, 2 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.

• Ke Ola Kino Physical Therapy, LLC

  • Physical Therapist
  • Hilo, HI
  • NPI 1093234759
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1261094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523577600000",
    "number": "1578892675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2064 KILAUEA AVE",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967205233",
            "telephone_number": "808-339-7478",
            "fax_number": "808-657-4980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2064 KILAUEA AVE",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967205233",
            "telephone_number": "808-339-7478",
            "fax_number": "808-657-4980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALLETT",
        "first_name": "MALIA",
        "middle_name": "PUA LOKELANI",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-18",
        "last_updated": "2018-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "PT34397",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT34397",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "3170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALIA",
            "last_name": "PRUETT",
            "middle_name": "PUA LOKELANI",
            "prefix": "MRS.",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ellsworth H Takata Jr., D.D.S.
• Terri Takayesu
• Naomi Takemoto-Chock, PH.D.
• Colleen Michiko Talich, RN
• Talkdoctors LLC
• Brent Tamashiro
• Sean Tamura
• Robert I Tanaka, D.C
• Nicole T Tanigawa, MT
• Roberta Tanner, APRN-RX, FNP-C

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2018; 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.