Individual provider Active NPI

Jesse Roger Pasag, P.T., D.P.T.

  • Physical Therapist
  • Kalaheo, HI
National Provider Identifier
1962699694
Registry record updated Apr 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3186 Issued in HI
Practice address
2-2514 Kaumualii Hwy
211
Kalaheo, HI 96741-8303
Phone
(808) 495-8668
Fax
(808) 495-8669
NPI assigned
Sep 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2016

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 33833 CA
Physical Therapist 225100000X 3186 HI Primary

Addresses

Primary practice location

2-2514 Kaumualii Hwy
211
Kalaheo, HI 96741-8303

Mailing address

2-2514 Kaumualii Hwy
211
Kalaheo, HI 96741-8303
Phone (808) 495-8668

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100416000644 HI Practitioner - Physical Therapist in Private Practice 0042347411 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rehabilitation and Orthopedic Center of KauaiGroup PAC ID 7012208739, 2 clinicians

Practice addresses (Care Compare)

2-2514 Kaumualii Hwy
Suite 211
Kalaheo, HI 96741-8304
Phone (808) 495-8668

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33833CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabilitation and Orthopedic Center of Kauai Physical Therapist CurrentSince Jun 1, 2016 Accepting new patients
Hawaii Sports and Balance Center Physical Therapist Past Accepting new patients

Locations

2-2514 Kaumualii Hwy
Ste 211
Kalaheo, HI 96741
Phone (808) 495-8668

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": "1190764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459987200000",
    "number": "1962699694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2-2514 KAUMUALII HWY",
            "address_2": "211",
            "city": "KALAHEO",
            "state": "HI",
            "postal_code": "967418303",
            "telephone_number": "808-495-8668",
            "fax_number": "808-495-8669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2-2514 KAUMUALII HWY",
            "address_2": "211",
            "city": "KALAHEO",
            "state": "HI",
            "postal_code": "967418303",
            "telephone_number": "808-495-8668",
            "fax_number": "808-495-8669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASAG",
        "first_name": "JESSE",
        "middle_name": "ROGER",
        "credential": "P.T., D.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-26",
        "last_updated": "2016-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "33833",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "3186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalaheo, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2016; 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.