Daniela Nicole Laird, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

AMD1299 Issued in HI

Practice address

67-1125 Mamalahoa Hwy
Kamuela, HI 96743-8496

Phone

(808) 885-4444

Fax

(808) 881-4404

NPI assigned

Aug 31, 2022

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

Other names 1

• Daniela Nicole De Kervor Former name

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Hawaii Emergency Physicians Associated Inc

  • Emergency Medicine Physician
  • Kailua, HI
  • NPI 1801843198
  Medicare reassignment
• Midpacific Hospitalists LLC

  • Internal Medicine Physician
  • Kailua, HI
  • NPI 1053778217
  NPD (past)

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

{
    "created_epoch": "1661904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1003536855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1266",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967341266",
            "telephone_number": "808-263-7202",
            "fax_number": "808-263-4604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67-1125 MAMALAHOA HWY",
            "city": "KAMUELA",
            "state": "HI",
            "postal_code": "967438496",
            "telephone_number": "808-885-4444",
            "fax_number": "808-881-4404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAIRD",
        "first_name": "DANIELA",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-31",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "HI",
            "license": "AMD1299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIELA",
            "last_name": "DE KERVOR",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kupuna Healthcare Services, LLC
• John Michael Kurap, M.D.
• Roberta J Kvenild, CNM
• Kirsten M.K. Kwan Wing
• L&R Dental, LLC
• Lyn M Lam, MD
• Darrell Peter Lapulapu, MAT, ACU
• Lawrence Derbes MD Inc.
• William S. Lawrence, M.D.
• Dennis Le, PHARMD

• Physician Assistant in Kamuela, HI
• Providers in Kamuela, HI by specialty
• Physician Assistant in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.