Individual provider Active NPI

Ryland Johnson, DPT

  • Physical Therapist
  • Honolulu, HI
National Provider Identifier
1639987886
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-6023 Issued in HI
Practice address
5722 Kalanianaole Hwy
Honolulu, HI 96821-2388
Phone
(808) 373-3555
NPI assigned
Dec 19, 2024
Last updated
Dec 19, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2024

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 PT-6023 HI Primary

Addresses

Primary practice location

5722 Kalanianaole Hwy
Honolulu, HI 96821-2388

Mailing address

1630 Lusitana St
Honolulu, HI 96813-1625

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250501000660 HI Practitioner - Physical Therapist in Private Practice 7113443250 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
Orthosport Hawaii, LLCGroup PAC ID 5890872634, 25 clinicians

Practice addresses (Care Compare)

5722 Kalanianaole Hwy
Honolulu, HI 96821-2388
Phone (808) 373-3555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
PT-6023HIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthosport Hawaii, LLC CurrentSince Jan 17, 2025 Accepting new patients
Orthosport Physical Therapy CurrentSince Dec 22, 2024 Accepting new patients

Locations

400 Keawe St
Ste 102
Honolulu, HI 96813
Phone (808) 208-8822

5722 Kalanianaole Hwy
Honolulu, HI 96821
Phone (808) 373-1114

745 Fort St
Ste 116
Honolulu, HI 96813
Phone (808) 373-3555

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": "1734566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1639987886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 LUSITANA ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968131625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5722 KALANIANAOLE HWY",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968212388",
            "telephone_number": "808-373-3555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "RYLAND",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-19",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "PT-6023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2024; 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.