Individual provider Active NPI

Christian Paul Roy

  • Physical Therapist
  • Kihei, HI
National Provider Identifier
1952766065
Registry record updated Jan 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4300 Issued in HI
Practice address
411 Huku Lii PL Ste 101
Kihei, HI 96753
Phone
(808) 879-0077
NPI assigned
Dec 17, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 010660 CT
Physical Therapist 225100000X 4300 HI Primary

Addresses

Primary practice location

411 Huku Lii PL Ste 101
Kihei, HI 96753

Mailing address

411 Huku Lii PL Ste 101
Kihei, HI 96753-7062
Phone (808) 879-0077

Other practice location 1

33 Hospital Ave
Danbury, CT 06810
Phone (203) 792-2164

Other practice location 2

1827 Wells St # 2
Wailuku, HI 96793-2370
Phone (808) 244-0077

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240402001654 TN Practitioner - Physical Therapist in Private Practice 5799062089 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Pittsburgh School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elite Sports Medicine and Orthopaedic Center PLCGroup PAC ID 8729009634, 90 clinicians

Practice addresses (Care Compare)

2004 Hayes St
Suite 200
Nashville, TN 37203-2689
Phone (615) 324-1600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4300HIMDClinical Social Worker
010660CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Sports Medicine and Orthopaedic Center, PLC CurrentSince Feb 26, 2024 Accepting new patients
Elite Sports Medicine and Orthopaedic Center, PLC CurrentSince Feb 26, 2024 Accepting new patients

Locations

2004 Hayes St
Ste 200
Nashville, TN 37203
Phone (615) 284-2000

Organizations & group practices 2

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": "1450310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548806400000",
    "number": "1952766065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 HUKU LII PL STE 101",
            "city": "KIHEI",
            "state": "HI",
            "postal_code": "967537062",
            "telephone_number": "808-879-0077",
            "fax_number": "808-879-0177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 HUKU LII PL STE 101",
            "city": "KIHEI",
            "state": "HI",
            "postal_code": "96753",
            "telephone_number": "808-879-0077"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "33 Hospital Ave",
            "address_purpose": "LOCATION",
            "city": "Danbury",
            "state": "CT",
            "postal_code": "06810",
            "country_code": "US",
            "telephone_number": "203-792-2164",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1827 Wells St # 2",
            "address_purpose": "LOCATION",
            "city": "Wailuku",
            "state": "HI",
            "postal_code": "967932370",
            "country_code": "US",
            "telephone_number": "808-244-0077",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROY",
        "first_name": "CHRISTIAN",
        "middle_name": "PAUL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-17",
        "last_updated": "2019-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "010660",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "4300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kihei, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2019; 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.