Individual provider Active NPI

Darcy S Ledesma, PT

  • Physical Therapist
  • Kihei, HI
National Provider Identifier
1821179060
Registry record updated Jan 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-2199 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
Oct 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 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 2199 HI
Physical Therapist 225100000X PT-2199 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) 244-5541

Other identifiers 2

IdentifierTypeStateIssuer
52758307MedicaidHI
5278305MedicaidHI

Other names 1

  • Darcy Stables Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050204000074 HI Practitioner - Physical Therapist in Private Practice 1153372305 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2199HIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Physical Therapy and Sports Physical Therapist CurrentSince Sep 13, 2018 Accepting new patients
Kahului Physical Therapy LLC Physical Therapist CurrentSince Aug 1, 2021 Accepting new patients
Physical Therapy and Wellness Center of Maui LLC Physical Therapist PastSince Nov 15, 2003 Accepting new patients
Community Clinic of Maui, Inc. Past Accepting new patients

Locations

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

1043 Makawao Ave
Ste 107
Makawao, HI 96768
Phone (808) 572-7790

6 Central Ave
Wailuku, HI 96793
Phone (808) 244-5541

Organizations & group practices 4

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643328000000",
    "number": "1821179060",
    "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": "808-244-5541",
            "fax_number": "808-242-8485"
        },
        {
            "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": "LEDESMA",
        "first_name": "DARCY",
        "middle_name": "S",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "2199",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "PT-2199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "52758307",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5278305",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DARCY",
            "last_name": "STABLES",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Jan 28, 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.