MR. JOHN T MIZOGUCHI (OTR) – Occupational Therapist, NPI 1376654392

MR. JOHN T MIZOGUCHI (OTR) is a healthcare provider. based in Kahului, Hawaii. specializing in Occupational Therapist. They hold the professional credentials OTR. They hold a License No. OT151 (HI). The NPI Number for MR. JOHN T MIZOGUCHI (OTR) is 1376654392

Main info

Male
43 Years Of Experience
Accepts Medicare Assignment
Name
MR. JOHN T MIZOGUCHI (OTR)
NPI
1376654392
Phone
(808) 877-8717
Address
111 HANA HWY STE 107
Enumeration Date
31 August 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8088364840
Graduation Year
1983 (43 years ago)
PAC ID
8123916053
Group Practice PAC ID
8123245370
Professional Enrollment ID
I20140902001674
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

Provider Addresses for MR. JOHN T MIZOGUCHI (OTR)

  • 111 HANA HWY STE 107

    KAHULUI, HI 967322300

    Phone: (808) 877-8717

    Fax: (808) 877-8718

    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: 2014-09-02

PECOS data refreshed: 2026-06-15

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
I20140902001674IOccupational 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 96732)

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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: 8123245370View full group profile
NameSpecialtyState
-HI
Physical Therapist In Private PracticeTX

Reviews

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Frequently asked questions

How is MR. JOHN T MIZOGUCHI (OTR) identified in CMS data?
CMS-hosted NPPES data lists MR. JOHN T MIZOGUCHI (OTR) with NPI 1376654392.
Can I rely on MR. JOHN T MIZOGUCHI (OTR) being an active provider?
As of the registry snapshot, MR. JOHN T MIZOGUCHI (OTR) is marked active.
What is MR. JOHN T MIZOGUCHI (OTR)'s primary classification?
Occupational Therapist is the headline specialty for MR. JOHN T MIZOGUCHI (OTR) here. Clinical services aligned with this taxonomy classification.
What address line appears for MR. JOHN T MIZOGUCHI (OTR)?
MR. JOHN T MIZOGUCHI (OTR)'s geographic hint is Kahului, Hawaii in our summary view.
Why does MR. JOHN T MIZOGUCHI (OTR) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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