Individual provider Active NPI

Thomas Kowalick, MSPT

  • Physical Therapist
  • Kihei, HI
National Provider Identifier
1861430035
Registry record updated Dec 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2580 Issued in HI
Practice address
122 Lanakila PL
Kihei, HI 96753-8931
Phone
(808) 463-7055
NPI assigned
Jun 2, 2006
Last updated
Dec 28, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2010

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 2580 HI Primary

Addresses

Primary practice location

122 Lanakila PL
Kihei, HI 96753-8931

Mailing address

122 Lanakila PL
Kihei, HI 96753-8931
Phone (808) 463-7055

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100514000319 HI Practitioner - Physical Therapist in Private Practice 2769494236 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

122 Lanakila PL
Kihei, HI 96753-8931
Phone (808) 463-7055

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2580HIMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kokua Physical Therapy LLC CurrentSince Jan 1, 2014 Accepting new patients

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, 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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293494400000",
    "number": "1861430035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 LANAKILA PL",
            "city": "KIHEI",
            "state": "HI",
            "postal_code": "967538931",
            "telephone_number": "808-463-7055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 LANAKILA PL",
            "city": "KIHEI",
            "state": "HI",
            "postal_code": "967538931",
            "telephone_number": "808-463-7055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWALICK",
        "first_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2010-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "2580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Dec 28, 2010; 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.