Organization Active NPI

Breakthrough Rehab, Inc.

  • Physical Therapist
  • Honolulu, HI
National Provider Identifier
1851483382
Registry record updated Mar 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
BREAKTHROUGH REHAB, INC.
Practice address
3465 Waialae Avenue
Suite 240
Honolulu, HI 96816
Phone
(808) 753-7617
Fax
(808) 735-3556
NPI assigned
Sep 29, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mr. Bert C Tada, PTNPI 1275636581
Title
President
Phone
(808) 753-7617

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Practitioners 5

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040323001559 HI Part B Supplier - Clinic/Group Practice 0345131827 Receives reassigned benefits from 2 practitioners
Practice locations: Honolulu, HI

National Provider Directory

National Provider Directory
Tax ID family
Breakthrough Rehab2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3465 Waialae Ave
Ste 240
Honolulu, HI 96816
Phone (808) 753-7617

3465 Waialae Ave
Ste 102
Honolulu, HI 96816
Phone (808) 753-7617

3465 Waialae Ave
Ste 420
Honolulu, HI 96816

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X

Addresses

NPPES NPI Registry

Primary practice location

3465 Waialae Avenue
Suite 240
Honolulu, HI 96816

Mailing address

3465 Waialae Avenue
Suite 240
Honolulu, HI 96816
Phone (808) 753-7617

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 19, 2010.

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268956800000",
    "number": "1851483382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3465 WAIALAE AVENUE",
            "address_2": "SUITE 240",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "96816",
            "telephone_number": "808-753-7617",
            "fax_number": "808-735-3556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3465 WAIALAE AVENUE",
            "address_2": "SUITE 240",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "96816",
            "telephone_number": "808-753-7617",
            "fax_number": "808-735-3556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREAKTHROUGH REHAB, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2010-03-19",
        "status": "A",
        "authorized_official_last_name": "TADA",
        "authorized_official_first_name": "BERT",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "808-753-7617",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.