Kriselle Gaea Miro Gines, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD-21921 Issued in HI

Practice address

2239 N School St
Honolulu, HI 96819-2539

Phone

(808) 791-9410

Fax

(808) 847-6051

NPI assigned

Apr 18, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Pediatric Medicine

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Riverside, CA
  • NPI 1316979834
  Medicare reassignment
• Kokua Kalihi Valley Comprehensive Family Services

  • Federally Qualified Health Center (FQHC)
  • Honolulu, HI
  • NPI 1114074622
  NPD (past)

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

{
    "created_epoch": "1524009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632268800000",
    "number": "1033606629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2239 N SCHOOL ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968192539",
            "telephone_number": "808-791-9410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2239 N SCHOOL ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968192539",
            "telephone_number": "808-791-9410",
            "fax_number": "808-847-6051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GINES",
        "first_name": "KRISELLE GAEA",
        "middle_name": "MIRO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-18",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "HI",
            "license": "MD-21921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cody Vincent Gilliss, PT, DPT
• George Gilmore
• Charles Warren Gima, ATC
• Lana H. Gimber, MD, MPH
• Gregory Gin
• Gino Clinic
• Gino Clinic, LLC (Gino Behavioral Health)
• Alexander Gino
• Alissa Gino, LMHC
• Amanda Maria Gino

• Pediatrics Physician in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Pediatrics Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2021; 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.