Individual provider Active NPI

Roshelle Venegas Balisi, PTA

  • Physical Therapy Assistant
  • Honolulu, HI
National Provider Identifier
1942796529
Registry record updated Jul 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
298 Issued in HI
Practice address
2226 Liliha St Ste 304
Honolulu, HI 96817-1605
Phone
(808) 547-6500
NPI assigned
Jul 6, 2018
Last updated
Jul 6, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 298 HI Primary

Addresses

Primary practice location

2226 Liliha St Ste 304
Honolulu, HI 96817-1605

Mailing address

94-790 Kaaka St
Waipahu, HI 96797-1298
Phone (808) 225-8604

Other practice location 1

94-790 Kaaka St
Waipahu, HI 96797-1298
Phone (808) 225-8604

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
298HIMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1530835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530835200000",
    "number": "1942796529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94-790 KAAKA ST",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967971298",
            "telephone_number": "808-225-8604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2226 LILIHA ST STE 304",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968171605",
            "telephone_number": "808-547-6500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "94-790 Kaaka St",
            "address_purpose": "LOCATION",
            "city": "Waipahu",
            "state": "HI",
            "postal_code": "967971298",
            "country_code": "US",
            "telephone_number": "808-225-8604",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALISI",
        "first_name": "ROSHELLE",
        "middle_name": "VENEGAS",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-06",
        "last_updated": "2018-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "HI",
            "license": "298",
            "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 Jul 6, 2018; 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.