Kelly Leialoha Luscomb, N.P.
Individual provider Active NPI Family Nurse Practitioner · Hilo, HI
NPI 1053746941 · NPPES record last updated Feb 11, 2015
Key facts
- NPI
- 1053746941
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- APRN-1641 (HI)
- Practice address
- 80 Pauahi St Ste 101
Hilo, HI 96720-3043 - Phone
- (808) 531-7222
- NPI assigned
- Sep 10, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 17
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Kau Hospital
Hilo Benioff Medical Center
Practice addresses (Care Compare)
1285 Waianuenue Ave
Hilo, HI 96720-1209
Phone (808) 432-3000
134 Puuhonu Way
Hilo, HI 96720-2066
Phone (808) 932-4225
Hospital & facility affiliations
- Hilo Benioff Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in HI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140519000367 | HI | Practitioner - Nurse Practitioner | 5395968499 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1641 | HI | MD | Counselor |
| APRN-1641 | HI | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kau Hospital | Current |
Accepting new patients | |
| West Hawaii Community Health Center, Inc. | Current | Accepting new patients | |
| Hilo Benioff Medical Center | Current | Accepting new patients | |
| West Hawaii Community Health Center, Inc. | Current |
Accepting new patients | |
| Kau Hospital | Current |
Accepting new patients | |
| West Hawaii Community Health Center, Inc. | Current |
Accepting new patients | |
| Hilo Benioff Medical Center | Current |
Accepting new patients | |
| Hilo Benioff Medical Center | Current |
Accepting new patients | |
| Kau Hospital | Current | Accepting new patients |
Locations
134 Puuhonu Way
Hilo, HI 96720
Phone (808) 935-1956
1190 Waianuenue Ave
Hilo, HI 96720
Phone (808) 932-3000
75 Puuhonu Pl
Ste 205
Hilo, HI 96720
Phone (808) 969-3331
450 Kilauea Ave
Ste 105
Hilo, HI 96720
Phone (808) 961-4071
1285 Waianuenue Ave
#2
Hilo, HI 96720
1178 Kinoole St
Hilo, HI 96720
Phone (808) 961-4082
16-192 Pili Mua St
Keaau, HI 96749
Phone (808) 930-0040
15-2866 Pahoa Village Rd
Bldg C
Pahoa, HI 96778
Phone (808) 965-9711
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APRN-1641 | HI | Yes |
Addresses
Primary practice location
80 Pauahi St Ste 101
Hilo, HI 96720-3043
Mailing address
80 Pauahi St Ste 101
Hilo, HI 96720-3043
Phone (808) 531-7222
Other providers in Hilo, HI
- Khadiga Seifalla Luce
- Chelsea K Ludwig
- Mandy Lynn Lui
- Maylayne Luis
- Keri Nanea Lum
- Jennifer Lyle
- Tazialynn Leilani Lynam
- Torrey Lynch
- Cynthia Ka'Apu Lyons
- Carolyn Sheong Jun Ma
All providers in Hilo, HI · Family Nurse Practitioner in Hawaii
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 11, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.