| Elam Sports Oahu | |
|
91-1027 Shangrila St Bldg 1867, Kapolei, HI 96707-2101 | |
| (808) 674-9595 | |
| (808) 674-9696 |
| Full Name | Elam Sports Oahu |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 91-1027 Shangrila St Bldg 1867, Kapolei, Hawaii |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316982523 | NPI | - | NPPES |
| 00A0218931 | Other | HI | HMSA |
| 50320201 | Medicaid | HI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | (* (Not Available)) | Primary |
| Provider Name | Trenton J Saupan |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1710338207 PECOS PAC ID: 8123314184 Enrollment ID: I20160831001405 |
| Provider Name | Vincent Frias |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1447832605 PECOS PAC ID: 7911307954 Enrollment ID: I20210614002363 |
| Provider Name | Kelsi Hendrix |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1902570435 PECOS PAC ID: 7012313836 Enrollment ID: I20210902001327 |
| Provider Name | Rick Martin Pezzullo |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1245724947 PECOS PAC ID: 4082960695 Enrollment ID: I20220407002566 |
| Provider Name | Adam J Radford |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1134732480 PECOS PAC ID: 3779996657 Enrollment ID: I20220621001232 |
| Provider Name | Jason Brenner |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1861267767 PECOS PAC ID: 1759732324 Enrollment ID: I20240108004907 |
| Mailing Address | Practice Location Address |
|---|---|
| Elam Sports Oahu Po Box 701119, Kapolei, HI 96709-1119 Ph: (808) 674-9595 | Elam Sports Oahu 91-1027 Shangrila St Bldg 1867, Kapolei, HI 96707-2101 Ph: (808) 674-9595 |
Jaco Rehab Kapolei, Llc Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 599 Farrington Hwy Ste 206, Kapolei, HI 96707 Phone: 808-381-8947 Fax: 808-591-2245 | |
Donovan Steven Turchin, PT, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 1001 Kamokila Blvd Ste 114, Kapolei, HI 96707 Phone: 808-674-0500 | |
Justin N R Magsanoc, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1001 Kamokila Blvd Ste 114, Kapolei, HI 96707 Phone: 808-674-0500 Fax: 808-674-0511 | |
Marc S Larson, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1001 Kamokila Blvd, #114, Kapolei, HI 96707 Phone: 808-674-0500 Fax: 808-674-0511 | |
Dr. Dana Lynn Fong-reyes, DPT, CSCS, TPI CGFI Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 599 Farrington Hwy, Suite 102, Kapolei, HI 96707 Phone: 808-674-1142 Fax: 808-674-1143 | |
Amy A Aronson, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1001 Kamokila Blvd Ste 114, Kapolei, HI 96707 Phone: 808-674-0500 | |
Amanda J Huckstep, MPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1001 Kamokila Blvd, Suite 111 Jcb, Kapolei, HI 96707 Phone: 808-674-9595 Fax: 808-674-9696 |