Individual provider Active NPI

Maya Laura Grodzka, DPT

  • Physical Therapist
  • Hilo, HI
National Provider Identifier
1972302404
Registry record updated Mar 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6106 Issued in HI
Practice address
69 Railroad Ave # A4
Hilo, HI 96720-7509
Phone
(808) 339-7861
NPI assigned
Mar 8, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2025

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 6106 HI Primary

Addresses

Primary practice location

69 Railroad Ave # A4
Hilo, HI 96720-7509

Mailing address

69 Railroad Ave # A4
Hilo, HI 96720-7509
Phone (808) 339-7861

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250401001444 HI Practitioner - Physical Therapist in Private Practice 4385167220 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Core Wellness Hawaii LLCGroup PAC ID 6406126762, 7 clinicians

Practice addresses (Care Compare)

69 Railroad Ave
Suite A4
Hilo, HI 96720-7509
Phone (808) 339-7861

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6106HIMDReflexologist

Practice roles

OrganizationSpecialtyStatusNew patients
Core Wellness Hawaii LLC Physical Therapist CurrentSince Mar 17, 2025 Accepting new patients

Locations

69 Railroad Ave
Ste A4
Hilo, HI 96720
Phone (808) 339-7861

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": "1741392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741392000000",
    "number": "1972302404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 RAILROAD AVE # A4",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967207509",
            "telephone_number": "808-339-7861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 RAILROAD AVE # A4",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967207509",
            "telephone_number": "808-339-7861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRODZKA",
        "first_name": "MAYA",
        "middle_name": "LAURA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-08",
        "last_updated": "2025-03-08",
        "certification_date": "2025-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "6106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilo, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 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.