Jackyline Sanchez Prestosa, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

MD-22593 Issued in HI

Practice address

91-6390 Kapolei Pkwy Ste 200
Ewa Beach, HI 96706-6380

Phone

(808) 691-8200

NPI assigned

May 8, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in HI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Queens University Medical GroupGroup PAC ID 2466831557, 614 clinicians

Primary Care Physician Enterprise LLCGroup PAC ID 0244661338, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The Queens Medical Center Hospital, Honolulu, HI, CCN 120001

Merit-based Incentive Payment System (MIPS)

Final score

97.05 of 100Reported as apm

Quality

89.81

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• HI PPO
• devoted network organization-c89d4c14-e90f-4cf7-83f9-456527a52335

Interoperability endpoints

• Direct secure messaging: jprestosa369972@direct.saint-lukes.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Primary Care Physician Enterprise LLC

  • Clinic/Center
  • Ewa Beach, HI
  • NPI 1164054763
  Medicare reassignment Care Compare group NPD
• Queens University Medical Group

  • Multi-Specialty Clinic/Center
  • Honolulu, HI
  • NPI 1891441382
  Medicare reassignment Care Compare group NPD
• The Queen'S Medical Center

  • General Acute Care Hospital
  • Honolulu, HI
  • NPI 1487693586
  Medicare reassignment NPD
• The Queens Medical Center

  • General Acute Care Hospital
  • Honolulu, HI
  • NPI 1184612764
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• The Queens Medical Center

  • General Acute Care Hospital
  • Honolulu, HI
  • NPI 1184612764
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1525737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662163200000",
    "number": "1003305749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91-6390 KAPOLEI PKWY STE 200",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967066380",
            "telephone_number": "808-691-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91-6390 KAPOLEI PKWY STE 200",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967066380",
            "telephone_number": "808-691-8200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1319 Punahou St Ste 824",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968261032",
            "country_code": "US",
            "telephone_number": "808-203-6518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRESTOSA",
        "first_name": "JACKYLINE",
        "middle_name": "SANCHEZ",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-08",
        "last_updated": "2022-09-03",
        "certification_date": "2022-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "HI",
            "license": "MDR7492",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "HI",
            "license": "MD-22593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cody Porter, PHARMD
• Positive Perspective LLC (D/B/a)
• Positive Shift Nutrition LLC
• Leah Prahl, ATR-P
• Kimi A Prentice, APRN
• Jean Prieto
• Primary Care Physician Enterprise LLC
• Amy Jo Prince, BS, GCMHP
• Denise Marie Pronesti, APRN
• Bryscen Prothero, APRN-RX, PNP

• Obstetrics & Gynecology Physician in Ewa Beach, HI
• Providers in Ewa Beach, HI by specialty
• Obstetrics & Gynecology Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.