Active NPI
Nataliya Gurevich Peck, LMT
- Massage Therapist
- Kapolei, HI
National Provider Identifier
1720449978
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MAT11861
- Practice address
- 92-960 Hunekai PL
Kapolei, HI 96707-1519 - Phone
- (808) 673-8276
- NPI assigned
- Mar 16, 2016
- Last updated
- Feb 10, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MAT11861 | HI | Primary |
Addresses
Primary practice location
92-960 Hunekai PL
Kapolei, HI 96707-1519
Mailing address
92-960 Hunekai PL
Kapolei, HI 96707-1519
Phone (808) 673-8276
Other practice location 1
91-579 Farrington Hwy
202
Kapolei, HI 96707
Phone (808) 673-8276
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 15705317 | Other | HI | CAQH |
Other names 1
- Nataliya Igorevna Gurevich-Peck
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MAT11861 | HI | MD | Massage Therapist |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Integrative Bodyworks Hawaii
- Massage Therapist
- Kapolei, HI
- NPI 1740837608
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458086400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675987200000",
"number": "1720449978",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "92-960 HUNEKAI PL",
"city": "KAPOLEI",
"state": "HI",
"postal_code": "967071519",
"telephone_number": "808-673-8276"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "92-960 HUNEKAI PL",
"city": "KAPOLEI",
"state": "HI",
"postal_code": "967071519",
"telephone_number": "808-673-8276"
}
],
"practiceLocations": [
{
"address_1": "91-579 Farrington Hwy",
"address_2": "202",
"address_purpose": "LOCATION",
"city": "Kapolei",
"state": "HI",
"postal_code": "96707",
"country_code": "US",
"telephone_number": "808-673-8276",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PECK",
"first_name": "NATALIYA",
"middle_name": "GUREVICH",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-16",
"last_updated": "2023-02-10",
"certification_date": "2023-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "HI",
"license": "MAT11861",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "15705317",
"state": "HI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "NATALIYA",
"last_name": "GUREVICH-PECK",
"middle_name": "IGOREVNA",
"credential": "LMT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Kapolei, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.