Individual provider Active NPI

Kelly Marie Paschke, DO

  • Interventional Cardiology Physician
  • Honolulu, HI
National Provider Identifier
1205221827
Registry record updated Aug 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
DOS-2432 Issued in HI
Practice address
550 S Beretania St Ste 702
Honolulu, HI 96813-2496
Phone
(808) 691-8808
Fax
(808) 691-8861
NPI assigned
Mar 31, 2015
Last updated
Aug 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 34.013444 OH
Cardiovascular Disease Physician 207RC0000X DOS-2432 HI
Interventional Cardiology Physician 207RI0011X DOS-2432 HI Primary

Addresses

Primary practice location

550 S Beretania St Ste 702
Honolulu, HI 96813-2496

Mailing address

550 S Beretania St Ste 702
Honolulu, HI 96813-2496
Phone (808) 691-8808

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230807003960 HI Practitioner - Interventional Cardiology 2961704846 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Cardiology
Education
Lake Erie College of Osteopathic Medicine, Erie, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Queens University Medical GroupGroup PAC ID 2466831557, 614 clinicians

Practice addresses (Care Compare)

550 S Beretania St
Suite 702
Honolulu, HI 96813-2496
Phone (808) 691-8808

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.05 of 100Reported as apm
Quality
89.81
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting64
Pacemaker insertion or repair1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DOS-2432HIMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Queens Medical Center CurrentSince Jul 26, 2023 Accepting new patients
The Queen's Medical Center Current Accepting new patients
The Queens Medical Center CurrentSince Jul 26, 2023 Accepting new patients
Queens University Medical Group CurrentSince Jul 26, 2023 Accepting new patients

Locations

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

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

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

550 S Beretania St
Ste 702
Honolulu, HI 96813
Phone (808) 691-8808

Networks

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

Organizations & group practices 4

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 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": "1427760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691020800000",
    "number": "1205221827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 S BERETANIA ST STE 702",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132496",
            "telephone_number": "808-691-8808",
            "fax_number": "808-691-8861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 S BERETANIA ST STE 702",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132496",
            "telephone_number": "808-691-8808",
            "fax_number": "808-691-8861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASCHKE",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-31",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "34.013444",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "HI",
            "license": "DOS-2432",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "HI",
            "license": "DOS-2432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.