Individual provider Active NPI

Maybellene Duque Degamo

  • Community Health Worker
  • Waipahu, HI
National Provider Identifier
1215852413
Registry record updated Aug 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
License
1-260018 Issued in HI
Practice address
94-106 Poloai Way
Waipahu, HI 96797-5805
Phone
(808) 725-0675
Fax
(808) 200-0114
NPI assigned
Aug 13, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 172V00000X 1-260018 HI Primary

Addresses

Primary practice location

94-106 Poloai Way
Waipahu, HI 96797-5805

Mailing address

94-106 Poloai Way
Waipahu, HI 96797-5805
Phone (808) 725-0675

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1786579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786579200000",
    "number": "1215852413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94-106 POLOAI WAY",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967975805",
            "telephone_number": "808-725-0675",
            "fax_number": "808-200-0114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94-106 POLOAI WAY",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967975805",
            "telephone_number": "808-725-0675",
            "fax_number": "808-200-0114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGAMO",
        "first_name": "MAYBELLENE",
        "middle_name": "DUQUE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-08-13",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Community Health Worker",
            "state": "HI",
            "license": "1-260018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waipahu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.