Individual provider Active NPI

Jordan Anthony Kauiokalani Genovia, DPT, BS

  • Physical Therapist
  • Aiea, HI
National Provider Identifier
1639032089
Registry record updated Dec 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6223 Issued in HI
Practice address
98-211 Pali Momi St Ste 300
Aiea, HI 96701-4318
Phone
(808) 456-5888
Fax
(808) 455-6936
NPI assigned
Dec 3, 2025
Last updated
Dec 3, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2025

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 6223 HI Primary

Addresses

Primary practice location

98-211 Pali Momi St Ste 300
Aiea, HI 96701-4318

Mailing address

98-211 Pali Momi St Ste 300
Aiea, HI 96701-4318
Phone (808) 456-5888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI, WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20260608004001 HI Practitioner - Physical Therapist in Private Practice 9436620663 Reassigns benefits to 1 organization
I20260617000853 WA Practitioner - Physical Therapist in Private Practice 9436620663 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Apple Physical Therapy LLCGroup PAC ID 7810892072, 285 clinicians

Practice addresses (Care Compare)

15614 Meridian E
Suite 100
Puyallup, WA 98375-5100
Phone (253) 840-5511

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
6223HIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sportsmedicine Hawaii LTD Physical Therapist CurrentSince Dec 7, 2025 Accepting new patients

Locations

98-211 Pali Momi St
Ste 300
Aiea, HI 96701
Phone (808) 456-5888

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1764720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764720000000",
    "number": "1639032089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98-211 PALI MOMI ST STE 300",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967014318",
            "telephone_number": "808-456-5888",
            "fax_number": "808-455-6936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98-211 PALI MOMI ST STE 300",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967014318",
            "telephone_number": "808-456-5888",
            "fax_number": "808-455-6936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENOVIA",
        "first_name": "JORDAN",
        "middle_name": "ANTHONY KAUIOKALANI",
        "credential": "DPT, BS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-12-03",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "6223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiea, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.