Active NPI
Junriel Roa, PT
- Physical Therapist
- Dededo, GU
National Provider Identifier
1609267947
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT-128
- Practice address
- 133 Route 3
Dededo, GU 96929-6911 - Phone
- (671) 645-5500
- Fax
- (671) 645-5549
- NPI assigned
- Feb 9, 2015
- Last updated
- Jul 19, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT-3932 | HI | |
| Physical Therapist | 225100000X | PT-128 | GU | Primary |
Addresses
Primary practice location
133 Route 3
Dededo, GU 96929-6911
Mailing address
PO Box 970277
Waipahu, HI 96797-0277
Other practice location 1
94-229 Waipahu Depot St
Suite 304
Waipahu, HI 96797-3031
Phone (808) 391-7678
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT-128 | GU | MD | Physical Therapist |
| PT-3932 | HI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1423440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531958400000",
"number": "1609267947",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 970277",
"city": "WAIPAHU",
"state": "HI",
"postal_code": "967970277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "133 ROUTE 3",
"city": "DEDEDO",
"state": "GU",
"postal_code": "969296911",
"telephone_number": "671-645-5500",
"fax_number": "671-645-5549"
}
],
"practiceLocations": [
{
"address_1": "94-229 Waipahu Depot St",
"address_2": "Suite 304",
"address_purpose": "LOCATION",
"city": "Waipahu",
"state": "HI",
"postal_code": "967973031",
"country_code": "US",
"telephone_number": "808-391-7678",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROA",
"first_name": "JUNRIEL",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-02-09",
"last_updated": "2018-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "HI",
"license": "PT-3932",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GU",
"license": "PT-128",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dededo, GU
- Doris Marquez Querimit
- Ran-Care, Inc. (Express Med Pharmacy)
- Christina M. Rapadas, DDS
- Reef Shark Peds LLC (One Love Pediatrics Dededo)
- Renal Centers of Guam, LLC (U.S. Renal Care Dededo Dialysis)
- Jennifer K Ross, BCHIS
- Joel Marc C Rubio, MD
- Manilyn Sarinas Salalila, RN
- Elizabeth Dizon Santos, AGNP-C
- Edmund Schroeder Jr., MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.