Individual provider Active NPI

Edward Tyler, DPT

  • Physical Therapist
  • Kaneohe, HI
National Provider Identifier
1851827570
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
47-388 Hui Iwa St
Ste 21B
Kaneohe, HI 96744-4416
Phone
(808) 233-9219
Fax
(808) 444-3744
NPI assigned
May 2, 2017
Last updated
Aug 23, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

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 Primary

Addresses

Primary practice location

47-388 Hui Iwa St
Ste 21B
Kaneohe, HI 96744-4416

Mailing address

46-036 Kam Hwy Unit 5124
Kaneohe, HI 96744-7711
Phone (808) 233-9219

Other practice location 1

970 N Kalaheo Ave
Kailua, HI 96734-1866
Phone (808) 488-5555

Other identifiers 1

IdentifierTypeStateIssuer
815293MedicaidHI

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/interconnect-prodhim/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170622002844 HI Practitioner - Physical Therapist in Private Practice 6901174572 Reassigns benefits to 1 organization
Practice locations: Kaneohe, HI

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

47 -388 Hui Iwa St
Suite 21B
Kaneohe, HI 96744-4416
Phone (808) 233-9219

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan Inc Current Accepting new patients
Kaiser Foundation Health Plan, Inc CurrentSince Apr 22, 2022 Accepting new patients
Kaiser Foundation Health Plan Inc CurrentSince Apr 22, 2022 Accepting new patients
Eleu Physical Therapy CurrentSince Jul 10, 2019 Accepting new patients
Warfighter's Clinic PastSince May 5, 2017 Accepting new patients
Elam Sports, Inc. Physical Therapist Past Accepting new patients

Locations

1010 Pensacola St
Honolulu, HI 96814
Phone (808) 432-2000

711 Kapiolani Blvd
Honolulu, HI 96813
Phone (808) 432-5312

45-602 Kamehameha Hwy
Kaneohe, HI 96744
Phone (808) 432-3800

47-388 Hui Iwa St
Ste 21B
Kaneohe, HI 96744
Phone (757) 947-6006

599 Farrington Hwy
Kapolei, HI 96707
Phone (808) 432-3600

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1493683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1851827570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46-036 KAM HWY UNIT 5124",
            "city": "KANEOHE",
            "state": "HI",
            "postal_code": "967447711",
            "telephone_number": "808-233-9219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47-388 HUI IWA ST",
            "address_2": "STE 21B",
            "city": "KANEOHE",
            "state": "HI",
            "postal_code": "967444416",
            "telephone_number": "808-233-9219",
            "fax_number": "808-444-3744"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "970 N Kalaheo Ave",
            "address_purpose": "LOCATION",
            "city": "Kailua",
            "state": "HI",
            "postal_code": "967341866",
            "country_code": "US",
            "telephone_number": "808-488-5555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TYLER",
        "first_name": "EDWARD",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-02",
        "last_updated": "2022-08-23",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "815293",
            "state": "HI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodhim/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "45-602 Kamehameha Hwy",
            "city": "Kaneohe",
            "state": "HI",
            "country_code": "US",
            "postal_code": "967442017",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kaneohe, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 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.