Individual provider Active NPI

Mark T Herrington, APRN

  • Family Nurse Practitioner
  • Honolulu, HI
National Provider Identifier
1093790503
Registry record updated Aug 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN-648 Issued in HI
Practice address
550 S Beretania St Ste 601
Honolulu, HI 96813-2423
Phone
(808) 691-8877
NPI assigned
Dec 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN092969 AZ
Family Nurse Practitioner 363LF0000X APRN-648 HI Primary

Addresses

Primary practice location

550 S Beretania St Ste 601
Honolulu, HI 96813-2423

Mailing address

550 S Beretania St Ste 601
Honolulu, HI 96813-2423
Phone (808) 691-8877

Other identifiers 1

IdentifierTypeStateIssuer
713497MedicaidAZ

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
I20040601000617 HI Practitioner - Nurse Practitioner 2567443948 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Life Care Physician Services LLCGroup PAC ID 5395861306, 18 clinicians

Practice addresses (Care Compare)

78 -6957 Kamehameha III Rd
Kailua Kona, HI 96740-2528
Phone (808) 332-2790

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

Practice roles

OrganizationSpecialtyStatusNew patients
Queens University Medical Group CurrentSince Apr 22, 2022 Accepting new patients
The Queen'S Medical Center CurrentSince Dec 14, 2019 Accepting new patients
Life Care Physician Services, LLC CurrentSince Jan 1, 2025 Accepting new patients
The Queens Medical Center CurrentSince Dec 14, 2019 Accepting new patients

Locations

944 W Kawailani St
Hilo, HI 96720
Phone (808) 896-5661

1333 Waianuenue Ave
Hilo, HI 96720
Phone (808) 896-5661

550 S Beretania St
Ste 404
Honolulu, HI 96813
Phone (808) 691-8897

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

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

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

Networks

  • HI PPO
  • devoted network organization-c89d4c14-e90f-4cf7-83f9-456527a52335

Organizations & group practices 4

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": "1134000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596499200000",
    "number": "1093790503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 S BERETANIA ST STE 601",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132423",
            "telephone_number": "808-691-8877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 S BERETANIA ST STE 601",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132423",
            "telephone_number": "808-691-8877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRINGTON",
        "first_name": "MARK",
        "middle_name": "T",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-08",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "RN092969",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "APRN-648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "713497",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.