Individual provider Active NPI

Matthew D. Eller, PT

  • Physical Therapist
  • Kihei, HI
National Provider Identifier
1710085774
Registry record updated Mar 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-1855 Issued in HI
Practice address
2395 S Kihei Rd
Ste 206
Kihei, HI 96753-8635
Phone
(808) 873-8478
Fax
(808) 874-0501
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 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 PT-1855 HI Primary

Addresses

Primary practice location

2395 S Kihei Rd
Ste 206
Kihei, HI 96753-8635

Mailing address

2395 S Kihei Rd
Ste 206
Kihei, HI 96753-8635
Phone (808) 873-8478

Other identifiers 2

IdentifierTypeStateIssuer
49330418MedicaidHI
00P0218441OtherHIHMSA BILLING NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051205000900 HI Practitioner - Physical Therapist in Private Practice 5991725939 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kahului Physical Therapy LLCGroup PAC ID 9335218767, 3 clinicians

Practice addresses (Care Compare)

2395 S Kihei Rd
Suite 206
Kihei, HI 96753-8635
Phone (808) 873-8478

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kahului Physical Therapy LLC Physical Therapist CurrentSince Sep 1, 2014 Accepting new patients
Therapeutic Associates of Maui, LLC Physical Therapist PastSince Sep 1, 2002 Accepting new patients
Physical Therapy Homecare Physical Therapist Past Accepting new patients
Elite Physical Therapy and Sports Physical Therapist PastSince Jan 9, 2017 Accepting new patients
Physical Therapy and Wellness Center of Maui LLC Physical Therapist PastSince Nov 15, 2003 Accepting new patients
Therapeutic Associates of Maui, LLC Past Accepting new patients

Locations

2395 S Kihei Rd
Ste 206
Kihei, HI 96753
Phone (808) 873-8478

Organizations & group practices 6

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488499200000",
    "number": "1710085774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2395 S KIHEI RD",
            "address_2": "STE 206",
            "city": "KIHEI",
            "state": "HI",
            "postal_code": "967538635",
            "telephone_number": "808-873-8478",
            "fax_number": "808-874-0501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2395 S KIHEI RD",
            "address_2": "STE 206",
            "city": "KIHEI",
            "state": "HI",
            "postal_code": "967538635",
            "telephone_number": "808-873-8478",
            "fax_number": "808-874-0501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLER",
        "first_name": "MATTHEW",
        "middle_name": "D.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2017-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "PT-1855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "49330418",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA BILLING NUMBER",
            "identifier": "00P0218441",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kihei, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.