Jane Balitsky, RN, CNP
Individual provider Active NPI Gerontology Nurse Practitioner · Kahului, HI
NPI 1144249392 · NPPES record last updated Apr 8, 2021
Key facts
- NPI
- 1144249392
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Gerontology Nurse Practitioner 363LG0600X
- License
- R131899-5 (MN)
- Practice address
- 203 Ho-Ohana Street
Kahului, HI 96732 - Phone
- (808) 873-3684
- NPI assigned
- Jul 19, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in HI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210324000123 | HI | Order and Referring Only - Nurse Practitioner | 4284687153 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R131899-5 | MN | MD | Gerontology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan, Inc | Past |
Accepting new patients | |
| Kaiser Foundation Health Plan Inc | Past |
Accepting new patients | |
| Evercare Collaborative Solutions Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | R131899-5 | MN | Yes |
Addresses
Primary practice location
203 Ho-Ohana Street
Kahului, HI 96732
Mailing address
203 Hoohana St
Kahului, HI 96732-2476
Phone (808) 385-0158
Other practice location 1
3400 W 66th St Ste 290
Mn006-W600
Edina, MN 55435-2133
Phone (952) 914-1745
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5774578-00 | Medicaid | MN |
Other providers in Kahului, HI
- Jennifer Baba
- Vanessa Baggs
- Karen McCoy Baker
- Liza Rose Ibanez Balacang
- Rya Joy Baligad
- Jennifer C Ban
- Arnel Abasolo Banchiran
- Josette Marie Barrett
- Krystianna Kaheanaleolani Emiko Bascar
- Kasey Batterton
All providers in Kahului, HI · Gerontology Nurse Practitioner in Hawaii
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 8, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.