Active NPI
Marianela Ruiz Jacob
- Family Nurse Practitioner
- Aiea, HI
National Provider Identifier
1124445119
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 1470
- Practice address
- 98-025 Hekaha St Ste 4
BLDG 4
Aiea, HI 96701-4904 - Phone
- (808) 488-9449
- NPI assigned
- Mar 27, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 1470 | HI | Primary |
Addresses
Primary practice location
98-025 Hekaha St Ste 4
BLDG 4
Aiea, HI 96701-4904
Mailing address
98-025 Hekaha St Suite 4
BLDG 4
Aiea, HI 96701
Phone (808) 488-9449
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1470 | HI | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395878400000",
"number": "1124445119",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "98-025 HEKAHA ST SUITE 4",
"address_2": "BLDG 4",
"city": "AIEA",
"state": "HI",
"postal_code": "96701",
"telephone_number": "808-488-9449"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "98-025 HEKAHA ST STE 4",
"address_2": "BLDG 4",
"city": "AIEA",
"state": "HI",
"postal_code": "967014904",
"telephone_number": "808-488-9449"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOB",
"first_name": "MARIANELA",
"middle_name": "RUIZ",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-03-27",
"last_updated": "2014-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "HI",
"license": "1470",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aiea, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.