Individual provider Active NPI

Lisha K. Moffat, P.T.

  • Physical Therapist
  • Honolulu, HI
National Provider Identifier
1942592589
Registry record updated Mar 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2301 Issued in HI
Practice address
2670 Pacific Heights Rd
Honolulu, HI 96813-1049
Phone
(808) 524-1955
Fax
(808) 537-5418
NPI assigned
May 13, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2014

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 2301 HI Primary

Addresses

Primary practice location

2670 Pacific Heights Rd
Honolulu, HI 96813-1049

Mailing address

1952 E Fort Union Blvd
Suite 100
Salt Lake City, UT 84121-6877
Phone (801) 456-8409

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Orthosport Hawaii, LLC PastSince Apr 28, 2014 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1305244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395014400000",
    "number": "1942592589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1952 E FORT UNION BLVD",
            "address_2": "SUITE 100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841216877",
            "telephone_number": "801-456-8409",
            "fax_number": "801-456-8413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2670 PACIFIC HEIGHTS RD",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968131049",
            "telephone_number": "808-524-1955",
            "fax_number": "808-537-5418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOFFAT",
        "first_name": "LISHA",
        "middle_name": "K.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-13",
        "last_updated": "2014-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "2301",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Mar 17, 2014; 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.