DR. DULYAWAT IMRAPORN (PT, DPT) – Orthopedic Physical Therapist, NPI 1104366913

DR. DULYAWAT IMRAPORN (PT, DPT) is a healthcare provider. based in Honolulu, Hawaii. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT, DPT. They hold a License No. PT291900 (CA). The NPI Number for DR. DULYAWAT IMRAPORN (PT, DPT) is 1104366913

Main info

Male
11 Years Of Experience
Accepts Medicare Assignment
Name
DR. DULYAWAT IMRAPORN (PT, DPT)
NPI
1104366913
Phone
(808) 680-9123
Address
500 ALA MOANA BLVD STE 6D
Enumeration Date
27 February 2017
Last Update Date
19 January 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8086809123
Graduation Year
2015 (11 years ago)
PAC ID
8729364708
Group Practice PAC ID
6406747351
Professional Enrollment ID
I20210708001309
Address ID
HI968134984HO500XXBLVD401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience56
Completeness75
Years active:9State licenses:2Digital endpointsOther names

9,449 PHYSICAL THERAPIST IN PRIVATE PRACTICE in CA

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Provider Addresses for DR. DULYAWAT IMRAPORN (PT, DPT)

  • 500 ALA MOANA BLVD STE 6D

    HONOLULU, HI 968134984

    Phone: (808) 680-9123

    Fax: (808) 680-9889

    Type: Mailing

  • 1106, Walnut Street, San Luis Obispo, San Luis Obispo County, California, 93410, United States

    SUITE 110

    SAN LUIS OBISPO, CA 934012416

    Phone: (805) 788-0805

    Fax: (805) 788-0845

    Type: Mailing

  • Doctor Carreon Boulevard, Indio, Riverside County, California, 92201, United States

    STE I

    INDIO, CA 922014832

    Phone: (760) 347-6195

    Fax: (760) 347-2849

    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: 2021-07-08

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20210708001309IPhysical Therapist In Private PracticeHITBD

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.

Verify on CMS Revalidation Lookup Tool

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 96813)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6406747351View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeHI
Physical Therapist In Private PracticeHI
Physical Therapist In Private PracticeAZ
Physical Therapist In Private PracticeHI
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeHI
Physical Therapist In Private PracticeHI
Physical Therapist In Private PracticeHI
Physical Therapist In Private PracticeWA
Physical Therapist In Private PracticeHI

Reviews

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Frequently asked questions

What identifier follows DR. DULYAWAT IMRAPORN (PT, DPT) across health systems?
The NPI 1104366913 uniquely identifies DR. DULYAWAT IMRAPORN (PT, DPT) in U.S. healthcare data.
Should I treat DR. DULYAWAT IMRAPORN (PT, DPT) as an active provider?
Patients and plans typically see DR. DULYAWAT IMRAPORN (PT, DPT) as active in the national extract.
How should patients interpret DR. DULYAWAT IMRAPORN (PT, DPT)'s specialty?
The extract shows Orthopedic Physical Therapist for DR. DULYAWAT IMRAPORN (PT, DPT). Clinical services aligned with this taxonomy classification.
Is DR. DULYAWAT IMRAPORN (PT, DPT) tied to Honolulu, Hawaii?
If you are local to Honolulu, Hawaii, DR. DULYAWAT IMRAPORN (PT, DPT) may be relevant to your search.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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