Individual provider Active NPI

Kal Peterman

  • Nurse Practitioner
  • Honolulu, HI
National Provider Identifier
1093480246
Registry record updated Oct 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN-3382 Issued in HI
Practice address
1585 Kapiolani Blvd Ste 1500
Honolulu, HI 96814-4526
Phone
(808) 531-6886
NPI assigned
Aug 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN-92233 HI
Nurse Practitioner 363L00000X APRN-3382 HI Primary

Addresses

Primary practice location

1585 Kapiolani Blvd Ste 1500
Honolulu, HI 96814-4526

Mailing address

4504 Sierra Dr
Honolulu, HI 96816-4024

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220215002472 HI Practitioner - Nurse Practitioner 9133512106 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
97.05 of 100Reported as apm
Quality
89.81
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN-92233HIMDRegistered Nurse
APRN-3382HIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Queens University Medical Group CurrentSince Nov 18, 2022 Accepting new patients
David Fitz-Patrick, MD Inc. CurrentSince Feb 2, 2022 Accepting new patients

Locations

1585 Kapiolani Blvd
Ste 1500
Honolulu, HI 96814
Phone (808) 440-4413

1301 Punchbowl St
Honolulu, HI 96813
Phone (808) 538-9011

550 S Beretania St
Ste 601
Honolulu, HI 96813
Phone (808) 691-8877

1380 Lusitana St
Ste 913
Honolulu, HI 96813
Phone (808) 691-8521

550 S Beretania St
Ste 202
Honolulu, HI 96813
Phone (808) 585-2900

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": "1628553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634515200000",
    "number": "1093480246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4504 SIERRA DR",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968164024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1585 KAPIOLANI BLVD STE 1500",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968144526",
            "telephone_number": "808-531-6886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERMAN",
        "first_name": "KAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-10",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "HI",
            "license": "RN-92233",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "HI",
            "license": "APRN-3382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.