Jared Medeiros

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN-1845 Issued in HI

Practice address

478 Lauhala Place
Lanai City, HI 96763

Phone

(808) 565-6919

Fax

(808) 565-9111

NPI assigned

Dec 4, 2014

Last updated

Dec 4, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 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

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lanai Community Health CenterGroup PAC ID 5395828925, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GEBABA/Endpoint/GEBABA

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

• Lanai Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Lanai City, HI
  • NPI 1679754097
  Medicare reassignment Care Compare group
• John J Cogan MD Inc

  • Interventional Cardiology Physician
  • Honolulu, HI
  • NPI 1396898557
  NPD (past)
• Lanai Community Health Center

  • Community/Retail Pharmacy
  • Lanai City, HI
  • NPI 1205413101
  NPD (past)
• West Hawaii Community Health Center, Inc.

  dba Hawaii Island Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Hilo, HI
  • NPI 1225086887
  NPD (past)

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

{
    "created_epoch": "1417651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417651200000",
    "number": "1043617103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 630142",
            "city": "LANAI CITY",
            "state": "HI",
            "postal_code": "967630142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "478 LAUHALA PLACE",
            "city": "LANAI CITY",
            "state": "HI",
            "postal_code": "96763",
            "telephone_number": "808-565-6919",
            "fax_number": "808-565-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDEIROS",
        "first_name": "JARED",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-12-04",
        "last_updated": "2014-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "APRN-1845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lanai Kinaole Inc
• Lanai Kinaole Inc
• Sharon Rae Liden, PH.D.
• Nicole Matsuda, RD
• Maui Health System a Kaiser Foundation Hospitals LLC (Lanai Community Hospital)
• Mental Health Kokua
• Janette Myers, APRN
• Nora K. Harmsen, D.D.S., Inc.
• Tulpe Julie Pablo, CNA
• Olivia Agtarap Pascual, FNP-BC

• Family Nurse Practitioner in Lanai City, HI
• Providers in Lanai City, HI by specialty
• Family Nurse Practitioner in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2014; 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.