Individual provider Active NPI

Katrina Chong Tercero, MHS, PA-C

  • Physician Assistant
  • Hilo, HI
National Provider Identifier
1174929772
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
52065 Issued in CA
Practice address
1285 Waianuenue Ave
Hilo, HI 96720-1209
Phone
(808) 932-3940
NPI assigned
Nov 8, 2014
Last updated
Apr 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X AMD-977 HI
Physician Assistant 363A00000X 52065 CA Primary

Addresses

Primary practice location

1285 Waianuenue Ave
Hilo, HI 96720-1209

Mailing address

1285 Waianuenue Ave
Hilo, HI 96720-1209

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
I20220512001222 HI Practitioner - Physician Assistant 3173894896 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kau HospitalGroup PAC ID 7416945548, 138 clinicians

Practice addresses (Care Compare)

1285 Waianuenue Ave
Hilo, HI 96720-1209
Phone (808) 432-3000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
52065CAMDMarriage & Family Therapist
AMD-977HIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kau Hospital CurrentSince Feb 3, 2022 Accepting new patients
Kau Hospital CurrentSince Feb 3, 2022 Accepting new patients

Locations

1285 Waianuenue Ave
Hilo, HI 96720
Phone (808) 932-3878

1285 Waianuenue Ave
#2
Hilo, HI 96720

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 2

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": "1415404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1174929772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1285 WAIANUENUE AVE",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967201209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1285 WAIANUENUE AVE",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967201209",
            "telephone_number": "808-932-3940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHONG TERCERO",
        "first_name": "KATRINA",
        "credential": "MHS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-08",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "HI",
            "license": "AMD-977",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "52065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilo, HI

Sources for this page

Verify at the official NPI Registry.