Kelly Matsuura, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1380 Issued in HI

Practice address

550 S Beretania St Ste 703
Honolulu, HI 96813-2496

Phone

(808) 691-4211

Fax

(808) 691-5388

NPI assigned

Apr 1, 2024

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in HI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Queens University Medical Group

  • Multi-Specialty Clinic/Center
  • Honolulu, HI
  • NPI 1891441382
  Medicare reassignment NPD

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

{
    "created_epoch": "1711929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1881445344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 S BERETANIA ST STE 703",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132496",
            "telephone_number": "808-691-4211",
            "fax_number": "808-691-5388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 S BERETANIA ST STE 703",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132496",
            "telephone_number": "808-691-4211",
            "fax_number": "808-691-5388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATSUURA",
        "first_name": "KELLY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-01",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "1380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne K Matsushima, O.D.
• James Matsushima
• Jodi M. Matsuura Eaves, MD
• Dari Shim Matsuura
• Jenna Matsuura, DPT
• Marjorie Matsuura, O.D.
• Pamela K. Matsuura, MD
• Eugene S. Matsuyama, M.D.
• Gerald N. Matsuyama, O.D.
• Judy Sayeko Matsuyama, RPH

• Physical Therapist in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Physical Therapist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2024; 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.