Individual provider Active NPI

Alina Dvortsen, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Honolulu, HI
National Provider Identifier
1174357693
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN47650 Issued in HI
Practice address
1374 Nuuanu Ave
Honolulu, HI 96817-4032
Phone
(808) 691-4401
Fax
(808) 691-7814
NPI assigned
Aug 27, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN47650 HI Primary

Addresses

Primary practice location

1374 Nuuanu Ave
Honolulu, HI 96817-4032

Mailing address

3412 Alohea Ave
Honolulu, HI 96816-2206
Phone (414) 737-6324

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
I20250219002525 HI Practitioner - Nurse Practitioner 8527588615 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Queens Medical CenterGroup PAC ID 3476454067, 191 clinicians

Practice addresses (Care Compare)

550 S Beretania St
Honolulu, HI 96813-2496

Hospital & facility affiliations

  • The Queens Medical Center Hospital, Honolulu, HI, CCN 120001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN47650HIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Queen'S Medical Center Current Accepting new patients
The Queens Medical Center CurrentSince Mar 7, 2025 Accepting new patients
Queens University Medical Group CurrentSince Mar 7, 2025 Accepting new patients
The Queens Medical Center CurrentSince Mar 7, 2025 Accepting new patients
The Queens Medical Center - Progressive Care Unit Past Accepting new patients
Optum Behavioral Care of Ohio, Inc. Past Accepting new patients
Optum Behavioral Care of Ohio, Inc Past Accepting new patients

Locations

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

1374 Nuuanu Ave
Honolulu, HI 96817
Phone (808) 547-4908

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

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

Organizations & group practices 7

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.

Hospital & facility affiliations 1

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": "1724716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1174357693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3412 ALOHEA AVE",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968162206",
            "telephone_number": "414-737-6324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1374 NUUANU AVE",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968174032",
            "telephone_number": "808-691-4401",
            "fax_number": "808-691-7814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DVORTSEN",
        "first_name": "ALINA",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-27",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "HI",
            "license": "APRN47650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.