OrganizationActive
Elite Physical Therapy and Sports
NPI 1235180811 · Physical Therapist · Makawao, HI
Provider details
- NPI number
- 1235180811
- Entity type
- Organization
- Primary specialty
- Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Organization subpart
- No
- Authorized official
- Mark Stack, Owner-Manager(808) 572-7790
- License
- W6201699001 (HI)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1043 Makawao Ave
Suite 107
Makawao, HI 96768-9465
Phone: (808) 572-7790
Fax: (808) 573-4721
Street-level locationGet directions
Mailing address
1043 Makawao Ave
Makawao, HI 96768-9465
Registry dates
- Enumerated
- 2006-05-16
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.