Individual provider Active NPI

Amrik Singh Sidhu, D.P.T.

  • Physical Therapist
  • Honolulu, HI
National Provider Identifier
1679817233
Registry record updated Nov 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-2888 Issued in HI
Practice address
1720 Huna St Apt 503
Honolulu, HI 96817-2462
Phone
(559) 304-4473
NPI assigned
Nov 20, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT-2888 HI Primary
Physical Therapist 225100000X PT-34372 CA

Addresses

Primary practice location

1720 Huna St Apt 503
Honolulu, HI 96817-2462

Mailing address

1720 Huna St Apt 503
Honolulu, HI 96817-2462
Phone (559) 304-4473

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220301001739 HI Practitioner - Physical Therapist in Private Practice 5395013411 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

101 E State St
Kennett Square, PA 19348-3109

2029 Lanihuli Dr
Honolulu, HI 96822-2112

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-34372CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Powerback Rehabilitation LLC Physical Therapist CurrentSince Jan 3, 2022 Accepting new patients
Powerback Rehabilitation LLC Physical Therapist CurrentSince Jan 3, 2022 Accepting new patients
Aloha Wound Care Group LLC Past Accepting new patients

Locations

1350 S King St
Ste 307
Honolulu, HI 96814
Phone (808) 342-1706

101 E State St
Kennett Square, PA 19348
Phone (610) 925-4436

Organizations & group practices 3

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": "1353369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353369600000",
    "number": "1679817233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 HUNA ST APT 503",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968172462",
            "telephone_number": "559-304-4473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 HUNA ST APT 503",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968172462",
            "telephone_number": "559-304-4473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDHU",
        "first_name": "AMRIK",
        "middle_name": "SINGH",
        "credential": "D.P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-11-20",
        "last_updated": "2012-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "PT-2888",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT-34372",
            "primary": false
        }
    ],
    "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 Nov 20, 2012; 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.