Individual provider Active NPI

Callie Elizabeth Rucker, DPT

  • Orthopedic Physical Therapist
  • Wahiawa, HI
National Provider Identifier
1598564783
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT-6114 Issued in HI
Practice address
1748 Wright Ave Unit 107
Wahiawa, HI 96786-6112
Phone
(918) 863-6191
NPI assigned
Mar 10, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT-6114 HI Primary

Addresses

Primary practice location

1748 Wright Ave Unit 107
Wahiawa, HI 96786-6112

Mailing address

1748 Wright Ave Unit 107
Wahiawa, HI 96786-6112
Phone (918) 863-6191

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250612000748 HI Practitioner - Physical Therapist in Private Practice 8820508328 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Quality Care Therapy LLCGroup PAC ID 5799798203, 9 clinicians

Practice addresses (Care Compare)

95 -1057 Ainamakua Dr
Suite F11
Mililani, HI 96789-6310
Phone (808) 597-1005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Care Therapy, LLC Orthopedic CurrentSince Mar 31, 2025 Accepting new patients
Moon Physical Therapy LLC Past Accepting new patients

Locations

201 Hamakua Dr
Ste C102
Kailua, HI 96734
Phone (808) 597-1005

201 Hamakua Dr
#C102
Kailua, HI 96734
Phone (808) 597-1005

95-1057 Ainamakua Dr
Ste F11
Mililani, HI 96789
Phone (808) 597-1005

Organizations & group practices 2

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": "1741564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1598564783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1748 WRIGHT AVE UNIT 107",
            "city": "WAHIAWA",
            "state": "HI",
            "postal_code": "967866112",
            "telephone_number": "918-863-6191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1748 WRIGHT AVE UNIT 107",
            "city": "WAHIAWA",
            "state": "HI",
            "postal_code": "967866112",
            "telephone_number": "918-863-6191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUCKER",
        "first_name": "CALLIE",
        "middle_name": "ELIZABETH",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-10",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "HI",
            "license": "PT-6114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wahiawa, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2025; 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.