Individual provider Active NPI

Bryan T Lee, D.P.T.

  • Orthopedic Physical Therapist
  • Honolulu, HI
National Provider Identifier
1881744225
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
1925 Issued in HI
Practice address
770 Kapiolani Blvd
Suite 104
Honolulu, HI 96813-5212
Phone
(808) 596-9446
Fax
(808) 596-9160
NPI assigned
Jan 10, 2007
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 1925 HI Primary

Addresses

Primary practice location

770 Kapiolani Blvd
Suite 104
Honolulu, HI 96813-5212

Mailing address

770 Kapiolani Blvd
Suite 104
Honolulu, HI 96813-5212
Phone (808) 596-9446

Other identifiers 10

IdentifierTypeStateIssuer
J0224970OtherHIHMSA BCBS#
200684033OtherHIHMAA #
200684033OtherHIUHC MEDICARE COMPLETE
201621OtherHIHMA SUMMERLIN
49621701MedicaidHI
Z1654OtherHIMDX INSURANCE CO
00J0224970OtherHIHMSA QUEST #
3953566OtherHIUHA #
49621702OtherHIALOHA CARE QUEST #
209006700OtherHIOWCP #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040625000048 HI Practitioner - Physical Therapist in Private Practice 6103801170 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
Group practices
Physical Therapy Associates LLCGroup PAC ID 5496730467, 8 clinicians

Practice addresses (Care Compare)

770 Kapiolani Blvd
Suite 104
Honolulu, HI 96813-5254
Phone (808) 596-9446

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1925HIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Associates, LLC Orthopedic CurrentSince Jun 14, 2004 Accepting new patients

Locations

770 Kapiolani Blvd
Ste 104
Honolulu, HI 96813
Phone (808) 596-9446

94-547 Ukee St
Ste 100
Waipahu, HI 96797
Phone (808) 596-9160

Organizations & group practices 1

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": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1881744225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 KAPIOLANI BLVD",
            "address_2": "SUITE 104",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968135212",
            "telephone_number": "808-596-9446",
            "fax_number": "808-596-9160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 KAPIOLANI BLVD",
            "address_2": "SUITE 104",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968135212",
            "telephone_number": "808-596-9446",
            "fax_number": "808-596-9160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "BRYAN",
        "middle_name": "T",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "HI",
            "license": "1925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA BCBS#",
            "identifier": "J0224970",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMAA #",
            "identifier": "200684033",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC MEDICARE COMPLETE",
            "identifier": "200684033",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMA SUMMERLIN",
            "identifier": "201621",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "49621701",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDX INSURANCE CO",
            "identifier": "Z1654",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA QUEST #",
            "identifier": "00J0224970",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHA #",
            "identifier": "3953566",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALOHA CARE QUEST #",
            "identifier": "49621702",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCP #",
            "identifier": "209006700",
            "state": "HI"
        }
    ],
    "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 Jul 9, 2007; 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.