Individual provider Active NPI

Michael K Maresca, PT

  • Physical Therapist
  • Honolulu, HI
National Provider Identifier
1992997266
Registry record updated Jul 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT - 1588 Issued in HI
Practice address
500 Ala Moana Blvd
Suite 1-302
Honolulu, HI 96813-4920
Phone
(808) 284-0824
Fax
(808) 739-0824
NPI assigned
Aug 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2011

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 PT - 1588 HI Primary

Addresses

Primary practice location

500 Ala Moana Blvd
Suite 1-302
Honolulu, HI 96813-4920

Mailing address

2258 Palolo Ave
Honolulu, HI 96816-3122
Phone (808) 284-0824

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040419001353 HI Practitioner - Physical Therapist in Private Practice 7810982766 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maresca Physical Therapy LLCGroup PAC ID 6406933449, 2 clinicians

Practice addresses (Care Compare)

1972 Iwi Way
Honolulu, HI 96816-3908
Phone (808) 548-0824

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT - 1588HIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Maresca Physical Therapy LLC Physical Therapist CurrentSince Oct 25, 2004 Accepting new patients
Elam Sports, Inc Physical Therapist PastSince Sep 13, 2020 Accepting new patients
Hawaii Physical Therapy, Inc. Physical Therapist Past Accepting new patients
Zeng Chiropractic Center LLC Past Accepting new patients
Windward Rehabilitation Services, LLC Physical Therapist Past Accepting new patients
Warfighter'S Clinic Past Accepting new patients
Fit Therapy LLC PastSince Nov 10, 2008 Accepting new patients
Elam Sports, Inc. Physical Therapist Past Accepting new patients
North Lake Physical Therapy and Rehabilitation, Inc. Physical Therapist Past Accepting new patients

Locations

500 Ala Moana Blvd
Ste 1300
Honolulu, HI 96813
Phone (808) 528-3657

500 Ala Moana Blvd
Ste 1302
Honolulu, HI 96813
Phone (808) 284-3601

Organizations & group practices 9

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": "1186704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311552000000",
    "number": "1992997266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2258 PALOLO AVE",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968163122",
            "telephone_number": "808-284-0824",
            "fax_number": "808-739-0824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 ALA MOANA BLVD",
            "address_2": "SUITE 1-302",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968134920",
            "telephone_number": "808-284-0824",
            "fax_number": "808-739-0824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARESCA",
        "first_name": "MICHAEL",
        "middle_name": "K",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-10",
        "last_updated": "2011-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "PT - 1588",
            "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 25, 2011; 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.