MRS. KELLIE C.M YANG (PT, DPT) – Physical Therapist, NPI 1205197779

MRS. KELLIE C.M YANG (PT, DPT) is a healthcare provider. based in Kapolei, Hawaii. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT, DPT. They hold a License No. 3463 (HI). The NPI Number for MRS. KELLIE C.M YANG (PT, DPT) is 1205197779

Main info

Female
15 Years Of Experience
Accepts Medicare Assignment
Name
MRS. KELLIE C.M YANG (PT, DPT)
NPI
1205197779
Phone
(808) 674-9595
Address
91-1027 SHANGRILA ST.,
Enumeration Date
31 May 2012
Last Update Date
31 May 2012

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8087839320
Graduation Year
2011 (15 years ago)
PAC ID
0244488328
Group Practice PAC ID
5193862175
Professional Enrollment ID
I20120914000147
Address ID
HI968251635HO7114XLOOP300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:14State licenses:1Digital endpointsOther names

615 PHYSICAL THERAPIST IN PRIVATE PRACTICE in HI

Provider Addresses for MRS. KELLIE C.M YANG (PT, DPT)

  • 91-1027 SHANGRILA ST.,

    BLDG 1867

    KAPOLEI, HI 967072101

    Phone: (808) 674-9595

    Fax: (808) 674-9696

    Mailing address matches the actual address.

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: 2012-09-14

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
I20120914000147IPhysical 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 96707)

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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: 5193862175View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeHI
Physical Therapist In Private PracticeFL
-TX
Physical Therapist In Private PracticeHI
Physical Therapist In Private PracticeHI
Physical Therapist In Private PracticeCA

Reviews

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Frequently asked questions

What is the standard ID for MRS. KELLIE C.M YANG (PT, DPT) in the U.S.?
In the U.S., MRS. KELLIE C.M YANG (PT, DPT) is identified by NPI 1205197779.
Is MRS. KELLIE C.M YANG (PT, DPT)'s NPI status active today?
Active status means MRS. KELLIE C.M YANG (PT, DPT)'s NPI record is not deactivated in the public file.
Which specialty label fits MRS. KELLIE C.M YANG (PT, DPT)?
NPPES ties MRS. KELLIE C.M YANG (PT, DPT) to Physical Therapist in the taxonomy section. Clinical services aligned with this taxonomy classification.
Can patients visit MRS. KELLIE C.M YANG (PT, DPT) in Kapolei, Hawaii?
For routing, start with Kapolei, Hawaii for MRS. KELLIE C.M YANG (PT, DPT), then verify phone and hours locally.
Why is information missing for MRS. KELLIE C.M YANG (PT, DPT)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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