Individual provider Active NPI

Kathryn M. Teal, P.T.

  • Physical Therapist
  • Honolulu, HI
National Provider Identifier
1659869709
Registry record updated Apr 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-4559 Issued in HI
Practice address
1401 S Beretania St Ste 550
Honolulu, HI 96814-1880
Phone
(808) 591-2244
Fax
(808) 591-2245
NPI assigned
Apr 24, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT-4559 HI Primary

Addresses

Primary practice location

1401 S Beretania St Ste 550
Honolulu, HI 96814-1880

Mailing address

1401 S Beretania St Ste 550
Honolulu, HI 96814-1880
Phone (808) 591-2244

Other identifiers 1

IdentifierTypeStateIssuer
99-0353213OtherHIUHA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180620003245 HI Practitioner - Physical Therapist in Private Practice 5698020378 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-4559HIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jaco Rehab Mililani Limited Partnership Physical Therapist CurrentSince Mar 1, 2020 Accepting new patients
Jaco Rehab Kapolei Limited Partnership Physical Therapist CurrentSince Mar 1, 2020 Accepting new patients
Jaco Rehab Honolulu Limited Partnership Physical Therapist CurrentSince Mar 1, 2020 Accepting new patients
Jaco Rehab Waikele Limited Partnership Physical Therapist CurrentSince Mar 1, 2020 Accepting new patients

Locations

1401 S Beretania St
Ste 550
Honolulu, HI 96814
Phone (808) 591-2244

599 Farrington Hwy
Ste 206
Kapolei, HI 96707
Phone (301) 421-1125

95-1105 Ainamakua Dr
Ste 203
Mililani, HI 96789
Phone (209) 770-6581

94-849 Lumiaina St
Unit 101
Waipahu, HI 96797
Phone (808) 536-8947

Organizations & group practices 4

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": "1524528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524528000000",
    "number": "1659869709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 S BERETANIA ST STE 550",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968141880",
            "telephone_number": "808-591-2244",
            "fax_number": "808-591-2245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S BERETANIA ST STE 550",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968141880",
            "telephone_number": "808-591-2244",
            "fax_number": "808-591-2245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEAL",
        "first_name": "KATHRYN",
        "middle_name": "M.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-24",
        "last_updated": "2018-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "PT-4559",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHA",
            "identifier": "99-0353213",
            "state": "HI"
        }
    ],
    "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 Apr 24, 2018; 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.