Individual provider Active NPI

Kenneth Ken Morimoto, DPT

  • Physical Therapist
  • Honolulu, HI
National Provider Identifier
1689114662
Registry record updated Feb 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT2688 Issued in HI
Practice address
200 N Vineyard Blvd Ste 151
Honolulu, HI 96817-3938
Phone
(808) 531-1122
NPI assigned
Feb 24, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2017

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 PT2688 HI Primary

Addresses

Primary practice location

200 N Vineyard Blvd Ste 151
Honolulu, HI 96817-3938

Mailing address

200 N Vineyard Blvd Ste 151
Honolulu, HI 96817-3938
Phone (808) 531-1122

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170412001395 HI Practitioner - Physical Therapist in Private Practice 7911283627 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Enso Physical Therapy LLCGroup PAC ID 0648703330, 3 clinicians

Practice addresses (Care Compare)

94 -1144 Ka Uka Blvd
Suite 16
Waipahu, HI 96797-4483
Phone (808) 531-2244

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT2688HIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Enso Physical Therapy LLC Physical Therapist CurrentSince Sep 17, 2024 Accepting new patients

Locations

94-1144 Ka Uka Blvd
Ste 16
Waipahu, HI 96797
Phone (808) 531-2244

94-1144 Ka Uka Blvd
Ste 16
Waipahu, HI 96797
Phone (808) 531-2244

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1487894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487894400000",
    "number": "1689114662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N VINEYARD BLVD STE 151",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968173938",
            "telephone_number": "808-531-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N VINEYARD BLVD STE 151",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968173938",
            "telephone_number": "808-531-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORIMOTO",
        "first_name": "KENNETH",
        "middle_name": "KEN",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-24",
        "last_updated": "2017-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "PT2688",
            "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 Feb 24, 2017; 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.