Individual provider Active NPI

Kenneth Mark Riff, M.D.

  • Internal Medicine Physician
  • Kailua Kona, HI
National Provider Identifier
1053765149
Registry record updated Apr 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
12450 Issued in HI
Practice address
75-169 Hualalai Rd Ste 301
Kailua Kona, HI 96740-3722
Phone
(808) 329-2114
NPI assigned
Apr 15, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 12450 HI Primary
Internal Medicine Physician 207R00000X 32424 MN

Addresses

Primary practice location

75-169 Hualalai Rd Ste 301
Kailua Kona, HI 96740-3722

Mailing address

67-1185 Mamalahoa Hwy Unit D104
Kamuela, HI 96743-8412
Phone (612) 670-8798

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190625003751 HI Practitioner - Internal Medicine 4981974508 Reassigns benefits to 1 organization
Practice locations: Kailua Kona, HI

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of California, San Francisco School of Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Five Mountains Hawaii, IncGroup PAC ID 4880817840, 10 clinicians

Practice addresses (Care Compare)

64-1035 Mamalahoa Hwy
Suite F
Kamuela, HI 96743-8440
Phone (808) 885-5900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
12450HIMDInternal Medicine Physician
32424MNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Five Mountains Hawaii, Inc CurrentSince Jun 20, 2019 Accepting new patients
Lokahi Health Center, Inc Past Accepting new patients

Locations

64-1035 Mamalahoa Hwy
Ste F
Kamuela, HI 96743
Phone (808) 885-5900

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/17479dfb-b021-49d0-9c8a-9247a410a2a3/

Organizations & group practices 2

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": "1460678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460678400000",
    "number": "1053765149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67-1185 MAMALAHOA HWY UNIT D104",
            "city": "KAMUELA",
            "state": "HI",
            "postal_code": "967438412",
            "telephone_number": "612-670-8798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75-169 HUALALAI RD STE 301",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967403722",
            "telephone_number": "808-329-2114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIFF",
        "first_name": "KENNETH",
        "middle_name": "MARK",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-15",
        "last_updated": "2016-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "12450",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "32424",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kailua Kona, HI

Sources for this page

Verify at the official NPI Registry.