Individual provider Active NPI

Ryan Conklin, MD

  • Emergency Medicine Physician
  • Kailua, HI
National Provider Identifier
1104405117
Registry record updated Jun 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD-25168-0 Issued in HI
Practice address
407 Uluniu St Ste 411
Kailua, HI 96734-2544
Phone
(808) 263-7202
NPI assigned
Apr 6, 2021
Last updated
Jun 4, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD-25168-0 HI Primary

Addresses

Primary practice location

407 Uluniu St Ste 411
Kailua, HI 96734-2544

Mailing address

407 Uluniu St Ste 411
Kailua, HI 96734-2544
Phone (808) 263-7202

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
I20250626001577 HI Practitioner - Emergency Medicine 1759893472 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hawaii Emergency Physicians Associated IncGroup PAC ID 2860390283, 119 clinicians

Practice addresses (Care Compare)

640 Ulukahiki St
Kailua, HI 96734-4454
Phone (808) 263-5164

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-25168-0HIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hawaii Emergency Physicians Associated Inc Emergency Medicine CurrentSince Jun 1, 2025 Accepting new patients
Midpacific Hospitalists LLC Past Accepting new patients

Locations

1190 Waianuenue Ave
Hilo, HI 96720
Phone (808) 932-3000

45-547 Plumeria St
Honokaa, HI 96727
Phone (808) 932-4100

56-117 Pualalea St
Kahuku, HI 96731
Phone (808) 293-9221

640 Ulukahiki St
Kailua, HI 96734
Phone (808) 261-3326

128 Lehua St
Wahiawa, HI 96786
Phone (808) 621-4330

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1617667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748995200000",
    "number": "1104405117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 ULUNIU ST STE 411",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967342544",
            "telephone_number": "808-263-7202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 ULUNIU ST STE 411",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967342544",
            "telephone_number": "808-263-7202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONKLIN",
        "first_name": "RYAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-06",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "HI",
            "license": "MD-25168-0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kailua, HI

Sources for this page

Verify at the official NPI Registry.