Individual provider Active NPI

Victor Riveiro Cruz

  • Physical Medicine & Rehabilitation Physician
  • Kailua, HI
National Provider Identifier
1639953466
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
PT-5768 Issued in HI
Practice address
407 Uluniu St
Kailua, HI 96734-2519
Phone
(808) 261-4321
NPI assigned
Aug 22, 2023
Last updated
Aug 22, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X PT-5768 HI Primary

Addresses

Primary practice location

407 Uluniu St
Kailua, HI 96734-2519

Mailing address

46-344 Nahewai St
Kaneohe, HI 96744-4151

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241004000624 HI Practitioner - Physical Therapist in Private Practice 2062943798 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-5768HIMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fukuji & Lum Physical Therapy Associates Inc. CurrentSince Sep 1, 2024 Accepting new patients

Locations

407 Uluniu St
Ste 301
Kailua, HI 96734
Phone (808) 261-4321

45-035 Kaneohe Bay Dr
Kaneohe, HI 96744
Phone (808) 234-5353

45-035 Kaneohe Bay Dr
Ste A
Kaneohe, HI 96744
Phone (808) 234-5353

Organizations & group practices 1

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": "1692662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1639953466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46-344 NAHEWAI ST",
            "city": "KANEOHE",
            "state": "HI",
            "postal_code": "967444151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 ULUNIU ST",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967342519",
            "telephone_number": "808-261-4321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVEIRO CRUZ",
        "first_name": "VICTOR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-22",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "HI",
            "license": "PT-5768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kailua, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.