Individual provider Active NPI

Meynard Villenas Enriquez, PT

  • Physical Therapist
  • Lihue, HI
National Provider Identifier
1689651002
Registry record updated Mar 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2583 Issued in HI
Practice address
3088A Aukele St
Lihue, HI 96766-1464
Phone
(808) 632-0033
NPI assigned
Dec 28, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2009

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 2583 HI Primary
Specialist 174400000X PT 29450 CA

Addresses

Primary practice location

3088A Aukele St
Lihue, HI 96766-1464

Mailing address

PO Box 288
Lihue, HI 96766-0288
Phone (808) 634-7055

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090514000290 HI Practitioner - Physical Therapist in Private Practice 7315927068 Receives reassigned benefits from 7 practitioners
Practice locations: Lihue, HI; Kapaa, HI

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3088 Aukele St
Lihue, HI 96766-2124
Phone (808) 632-0033

5633 Kawaihau Rd
BLDG 2a 12
Kapaa, HI 96746-2319
Phone (808) 378-4477

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 29450CAMDSpecialist
2583HIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Huntington Rehabilitation Medicine Associates Physical Therapist Past Accepting new patients

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238457600000",
    "number": "1689651002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 288",
            "city": "LIHUE",
            "state": "HI",
            "postal_code": "967660288",
            "telephone_number": "808-634-7055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3088A AUKELE ST",
            "city": "LIHUE",
            "state": "HI",
            "postal_code": "967661464",
            "telephone_number": "808-632-0033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENRIQUEZ",
        "first_name": "MEYNARD",
        "middle_name": "VILLENAS",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2009-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "2583",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "PT 29450",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lihue, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2009; 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.