Individual provider Active NPI

Nicole Pacer, OD

  • Optometrist
  • Wailuku, HI
National Provider Identifier
1013749431
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD-1044 Issued in HI
Practice address
450 Hookahi St
Wailuku, HI 96793-1474
Phone
(808) 877-3984
NPI assigned
Aug 14, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD-1044 HI Primary

Addresses

Primary practice location

450 Hookahi St
Wailuku, HI 96793-1474

Mailing address

30 Ahuwale PL
Makawao, HI 96768-8860
Phone (937) 499-4143

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240904001753 HI Practitioner - Optometry 2365982485 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aloha Eye Clinic, LTDGroup PAC ID 0941190805, 8 clinicians

Practice addresses (Care Compare)

450 Hookahi St
Wailuku, HI 96793-1474
Phone (808) 877-3984

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OD-1044HIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Aloha Eye Clinic, LTD. Optometrist CurrentSince Aug 1, 2024 Accepting new patients
Aloha Eye Clinic, LTD. Optometrist CurrentSince Aug 1, 2024 Accepting new patients
Aloha Eye Clinic Surgical Center LLC Current Accepting new patients

Locations

1300 N Holopono St
Ste 109
Kihei, HI 96753
Phone (808) 442-3058

450 Hookahi St
Wailuku, HI 96793
Phone (808) 244-5541

Networks

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

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1723593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1013749431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 AHUWALE PL",
            "city": "MAKAWAO",
            "state": "HI",
            "postal_code": "967688860",
            "telephone_number": "937-499-4143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 HOOKAHI ST",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967931474",
            "telephone_number": "808-877-3984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACER",
        "first_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-14",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "HI",
            "license": "OD-1044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wailuku, HI

Sources for this page

Verify at the official NPI Registry.