Individual provider Active NPI

Jun Bradley Lestino Cadelinia, PT, DPT

  • Physical Therapist
  • Kapolei, HI
National Provider Identifier
1740929975
Registry record updated Jul 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT5460 Issued in HI
Practice address
1001 Kamokila Blvd Ste 114
Kapolei, HI 96707-2095
Phone
(808) 674-0500
Fax
(808) 674-0511
NPI assigned
Jun 4, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2022

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-5460-0 HI
Physical Therapist 225100000X PT5460 HI Primary

Addresses

Primary practice location

1001 Kamokila Blvd Ste 114
Kapolei, HI 96707-2095

Mailing address

45-650 Pua Alowalo St
Kaneohe, HI 96744-2926
Phone (808) 203-4467

Other practice location 1

99-128 Aiea Heights Dr Ste 207
Aiea, HI 96701-3968
Phone (808) 487-0487

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220727003452 HI Practitioner - Physical Therapist in Private Practice 7214319920 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kailua Wellness Center LLCGroup PAC ID 5496891079, 5 clinicians

Practice addresses (Care Compare)

228 Kuulei Rd
Kailua, HI 96734-2720
Phone (808) 261-8181

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-5460-0HIMDPhysical Therapist
PT5460HIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kailua Wellness Center, LLC Physical Therapist CurrentSince Aug 24, 2023 Accepting new patients
Stayfit Physical Therapy LLC CurrentSince Jun 6, 2022 Accepting new patients

Locations

99-128 Aiea Heights Dr
Ste 207
Aiea, HI 96701
Phone (808) 487-0487

228 Kuulei Rd
Kailua, HI 96734
Phone (808) 261-8181

1001 Kamokila Blvd
Ste 114
Kapolei, HI 96707
Phone (808) 674-0500

Organizations & group practices 2

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": "1654300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1740929975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45-650 PUA ALOWALO ST",
            "city": "KANEOHE",
            "state": "HI",
            "postal_code": "967442926",
            "telephone_number": "808-203-4467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 KAMOKILA BLVD STE 114",
            "city": "KAPOLEI",
            "state": "HI",
            "postal_code": "967072095",
            "telephone_number": "808-674-0500",
            "fax_number": "808-674-0511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "99-128 Aiea Heights Dr Ste 207",
            "address_purpose": "LOCATION",
            "city": "Aiea",
            "state": "HI",
            "postal_code": "967013968",
            "country_code": "US",
            "telephone_number": "808-487-0487",
            "fax_number": "808-486-8674",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CADELINIA",
        "first_name": "JUN BRADLEY",
        "middle_name": "LESTINO",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-04",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "PT-5460-0",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "PT5460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 27, 2022; 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.