DR. RAY VICENTE SAN NICOLAS (PT, DPT) – Physical Therapist, NPI 1083438204
Physical Therapist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
615 PHYSICAL THERAPIST IN PRIVATE PRACTICE in HI
Provider Addresses for DR. RAY VICENTE SAN NICOLAS (PT, DPT)
3138 WAIALAE AVE APT 313
HONOLULU, HI 968161540
Phone: (808) 225-9767
Type: Mailing
3221 WAIALAE AVE STE 300
HONOLULU, HI 968165845
Phone: (808) 737-4244
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-01-17
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20250117001627 | I | Physical Therapist In Private Practice | HI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 96816)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physical Therapist In Private Practice | HI | |
| Physical Therapist In Private Practice | HI | |
| Physical Therapist In Private Practice | HI | |
| Physical Therapist In Private Practice | HI | |
| Physical Therapist In Private Practice | HI |
Reviews
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