Organization Active NPI

Performance Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Ewa Beach, HI
National Provider Identifier
1891724175
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
PT-1939 Issued in HI
Legal business name
PERFORMANCE PHYSICAL THERAPY LLC
Practice address
91-1488 Pukanala St
Ewa Beach, HI 96706-4678
Phone
(808) 308-5465
NPI assigned
Jun 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Authorized official

Name
Dr. Mark Gregory Pahang, PT, DPT, LMT
Title
Owner/Doctor of Physical Therapy
Phone
(808) 308-5465

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X PT-1939 HI Primary

Addresses

Primary practice location

91-1488 Pukanala St
Ewa Beach, HI 96706-4678

Mailing address

PO Box 970116
Waipahu, HI 96797-0116
Phone (808) 680-0600

National Provider Directory

National Provider Directory

Locations

94-366 Pupupani St
Ste 209B
Waipahu, HI 96797
Phone (808) 392-6361

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721606400000",
    "number": "1891724175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 970116",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967970116",
            "telephone_number": "808-680-0600",
            "fax_number": "808-680-0019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91-1488 PUKANALA ST",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967064678",
            "telephone_number": "808-308-5465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFORMANCE PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-30",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A",
        "authorized_official_last_name": "PAHANG",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "GREGORY",
        "authorized_official_title_or_position": "OWNER/DOCTOR OF PHYSICAL THERAPY",
        "authorized_official_telephone_number": "808-308-5465",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT, LMT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "HI",
            "license": "PT-1939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ewa Beach, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.