Individual provider Active NPI

Rowena Nikki Baysa, ARNP

  • Family Nurse Practitioner
  • Wailuku, HI
National Provider Identifier
1205409018
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3209 Issued in HI
Practice address
2180 Main St
Wailuku, HI 96793-1625
Phone
(808) 242-6464
NPI assigned
Jul 20, 2021
Last updated
Jul 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3209 HI Primary

Addresses

Primary practice location

2180 Main St
Wailuku, HI 96793-1625

Mailing address

504 Liholiho St
Wailuku, HI 96793-2615
Phone (904) 563-5389

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
I20210826001188 HI Practitioner - Nurse Practitioner 8820493018 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3209HIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Maui Medical Group Inc CurrentSince Sep 7, 2021 Accepting new patients
Nursing Care Hawaii CurrentSince Jul 25, 2021 Accepting new patients

Locations

2180 Main St
Wailuku, HI 96793
Phone (808) 242-6464

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.

NPI Registry JSON

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

{
    "created_epoch": "1626739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1205409018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 LIHOLIHO ST",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967932615",
            "telephone_number": "904-563-5389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2180 MAIN ST",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967931625",
            "telephone_number": "808-242-6464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAYSA",
        "first_name": "ROWENA NIKKI",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-20",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "3209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wailuku, HI

Sources for this page

Verify at the official NPI Registry.