Kelly Michele Cerutti, ANP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2300 Issued in HI

Practice address

925 California Avenue
CVS Minuteclinic #09300
Wahiawa, HI 96786

Phone

(808) 621-7772

NPI assigned

Aug 21, 2015

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Miss Kelly Michele Norwood Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2023 through Apr 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/9026/brand/1/csg/1/fhir/r4
• Direct secure messaging: kelly.cerutti.1@15729.direct.athenahealth.com
• Direct secure messaging: kelly.cerutti.1@9026.direct.athenahealth.com

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.

• North Shore Health and Wellness, LLC

  • Home Health Agency
  • Waialua, HI
  • NPI 1043721061
  NPD Authorized official
• Leland H. Dao, D.O. Inc

  dba Kaena Kai Clinic

  • Clinic/Center
  • Haleiwa, HI
  • NPI 1619234820
  NPD
• Avante Medical Center, LLC

  • Nurse Practitioner
  • Anchorage, AK
  • NPI 1891924163
  NPD (past)
• Columbia Lutheran Charities

  dba Lower Columbia Hospice

  • Community Based Hospice Care Agency
  • Astoria, OR
  • NPI 1023038858
  NPD (past)
• Columbia Lutheran Charities

  dba Columbia Memorial Hospital

  • Critical Access Hospital
  • Astoria, OR
  • NPI 1932814704
  NPD (past)

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

{
    "created_epoch": "1440115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1194192476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CVS MINUTECLINIC #09300",
            "address_2": "925 CALIFORNIA AVENUE",
            "city": "WAHIAWA",
            "state": "GA",
            "postal_code": "96786",
            "telephone_number": "808-621-7772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 CALIFORNIA AVENUE",
            "address_2": "CVS MINUTECLINIC #09300",
            "city": "WAHIAWA",
            "state": "HI",
            "postal_code": "96786",
            "telephone_number": "808-621-7772"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "66150 Kamehameha Hwy",
            "address_2": "Kaena Kai Clinic",
            "address_purpose": "LOCATION",
            "city": "Haleiwa",
            "state": "HI",
            "postal_code": "96712",
            "country_code": "US",
            "telephone_number": "808-637-8416",
            "fax_number": "888-509-7985",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CERUTTI",
        "first_name": "KELLY",
        "middle_name": "MICHELE",
        "name_prefix": "Mrs.",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-21",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "104121",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "22569",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "2300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "NORWOOD",
            "middle_name": "MICHELE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Carole Canales Navarrete, DH
• Krystel Capi Montijo
• Sandra Elizabeth Carlson, SLP
• Nicole Marie Napuanani Carter, DPT
• Center Pharmacy, Inc.
• Raquel Jenn Leun Chan-Ikeda, M.D.
• Kristi Anne Hidemi Chang Pacpaco, PHARMD
• Jorge Chanon, EMT-B
• Betty Seu Ming Chao, MFT
• Chiroplan Hawaii, Inc.

• Family Nurse Practitioner in Wahiawa, HI
• Providers in Wahiawa, HI by specialty
• Family Nurse Practitioner in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.