Sharon Dela Pena, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

818760 Issued in HI

Practice address

4643B Waimea Canyon Drive
Waimea, HI 96796

Phone

(808) 240-0100

Fax

(808) 338-1606

NPI assigned

Feb 6, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Hoola Lahui Hawaii

  • Federally Qualified Health Center (FQHC)
  • Waimea, HI
  • NPI 1245269976

  HI

  Medicare reassignment Care Compare group NPD
• Hoola Lahui Hawaii

  • Federally Qualified Health Center (FQHC)
  • Kapaa, HI
  • NPI 1891098513
  NPD
• Ho Ola Lahui Hawai I

  • Family Medicine Physician
  • Lihue, HI
  • NPI 1730828179

  Dietitian, Registered

  NPD (past)

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hoola Lahui Hawaii 12 clinicians

Practice addresses (Care Compare)

Medicare fee-for-service enrollment

Enrolled in HI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles (3 of 5)

Locations

Networks

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

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1154460137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3990",
            "city": "LIHUE",
            "state": "HI",
            "postal_code": "967666990",
            "telephone_number": "808-240-0100",
            "fax_number": "808-245-8867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4643B WAIMEA CANYON DRIVE",
            "city": "WAIMEA",
            "state": "HI",
            "postal_code": "96796",
            "telephone_number": "808-240-0100",
            "fax_number": "808-338-1606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELA PENA",
        "first_name": "SHARON",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "HI",
            "license": "818760",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "523979-01",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Surachat Chatkupt, M.D.
• Douglas E Ching, M.D.
• Damien Kapono Chong-Hanssen, M.D.
• Michael A Clark, M.D.
• Stephen D Coleman, M.D.
• Eliot A. Demello, MD
• Kenneth Fasig, DDS
• Sara Fromboluti, PST.D.
• Stephanie Funtanilla, BA
• Garden Island Pharmacy Serv, Inc

• All providers in Waimea, HI
• Registered Dietitian in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.