Tyler James Cooper, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-6095 Issued in HI

Practice address

75-165 Hualalai Rd Ste 100
Kailua Kona, HI 96740-3722

Phone

(808) 329-0591

NPI assigned

Aug 24, 2021

Reactivated

Jan 29, 2025

Last updated

Jan 29, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in HI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hawaiian Rehabilitation Services IncGroup PAC ID 5799811345, 10 clinicians

Practice addresses (Care Compare)

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

• Hawaiian Rehabilitation Services Inc

  • Rehabilitation Clinic/Center
  • Kailua Kona, HI
  • NPI 1518935162

  Physical Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1629763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1902573405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75-165 HUALALAI RD STE 100",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967403722",
            "telephone_number": "808-329-0591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75-165 HUALALAI RD STE 100",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967403722",
            "telephone_number": "808-329-0591"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3480 E Route 66",
            "address_purpose": "LOCATION",
            "city": "Flagstaff",
            "state": "AZ",
            "postal_code": "860044032",
            "country_code": "US",
            "telephone_number": "928-438-9985",
            "fax_number": "317-520-8200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOPER",
        "first_name": "TYLER",
        "middle_name": "JAMES",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-24",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "deactivation_date": "2025-01-23",
        "reactivation_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "PT-6095",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "AZ",
            "license": "RBT-21-181388",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Anne Colvin, PA-C
• Community Mental Health Center Clubhouse-Kona Paradise
• Compassionate Home Care
• Carol Conley
• Roselia Schlichtig Conrad, D.O.
• Jay Michael Copeland, PT, DPT
• Naomi C Corrales, CPHT
• Lori B. Correia, L.M.T.
• Michael T Corsale
• Leonardo Acosta Cortez, M.D.

• Physical Therapist in Kailua Kona, HI
• Providers in Kailua Kona, HI by specialty
• Physical Therapist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; 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.