Kellie Acosta, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

AMD-1055 Issued in HI

Practice address

75-5995 Kuakini Hwy Ste 513
Kailua Kona, HI 96740-2124

Phone

(808) 365-2297

NPI assigned

Jan 3, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in HI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Island Mobile Health Care

  • Clinic/Center
  • Kailua Kona, HI
  • NPI 1891580361
  NPD Authorized official

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

{
    "created_epoch": "1451779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1053777342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75-127 LUNAPULE RD STE 7E",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967402119",
            "telephone_number": "808-640-2660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75-5995 KUAKINI HWY STE 513",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967402124",
            "telephone_number": "808-365-2297"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75-127 Lunapule Rd Ste 7E",
            "address_purpose": "LOCATION",
            "city": "Kailua Kona",
            "state": "HI",
            "postal_code": "967402119",
            "country_code": "US",
            "telephone_number": "808-640-2660 x64026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ACOSTA",
        "first_name": "KELLIE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-03",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "HI",
            "license": "AMD-1055",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "HI",
            "license": "AMD-1055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAWAII PA LICENSE",
            "identifier": "AMD-1055",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lanette L Abraham-Duncan, LMT
• Ac Med LLC.
• Access Capabilities, Inc
• Ace 1 LLC
• Patricia Achay, P.A.
• Active Hawaii Physical Therapy, LLC
• Acute Care Clinic, Inc.
• Adapthealth West, LLC
• William Harold Adkins, MPT
• Advanced Wellness and Recovery LLC

• Medical Physician Assistant in Kailua Kona, HI
• Providers in Kailua Kona, HI by specialty
• Medical Physician Assistant in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.