Active NPI
Paul W. Grandon, MD
- Internal Medicine Physician
- Wailuku, HI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD-21227
- Practice address
- 55 Maui Lani Pkwy
Wailuku, HI 96793-2416 - Phone
- (808) 243-6050
- NPI assigned
- Jan 31, 2006
- Last updated
- Jul 25, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD-21227 | HI | Primary |
| Internal Medicine Physician | 207R00000X | 017275 | LA |
Addresses
Primary practice location
55 Maui Lani Pkwy
Wailuku, HI 96793-2416
Mailing address
55 Maui Lani Pkwy
Wailuku, HI 96793-2416
Phone (808) 243-6050
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 017275 | Other | LA | LICENSE |
| 1364738 | Medicaid | LA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/interconnect-prodhim/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA, HI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Louisiana State University School of Medicine in New Orleans, 1983
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
55 Maui Lani Pkwy
Wailuku, HI 96793-2416
Phone (808) 243-6050
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD-21227 | HI | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hawaii Permanente Medical Group Inc | Current | Accepting new patients | |
| Hospital Service District No 1-a of the Parish of Richland State of la | Current | Accepting new patients | |
| Hospital Service District No 1-a of the Parish of Richland State of la | Internal Medicine | Current | Accepting new patients |
Locations
3288 Moanalua Rd
Honolulu, HI 96819
Phone (808) 265-9205
711 Kapiolani Blvd
Honolulu, HI 96813
Phone (808) 432-5312
55 Maui Lani Pkwy
Wailuku, HI 96793
Phone (808) 243-6000
407 Cincinnati St
Delhi, LA 71232
Phone (318) 878-5171
501 Broadway St
Delhi, LA 71232
Phone (318) 878-6650
508 Broadway St
Delhi, LA 71232
Phone (318) 878-3737
Organizations & group practices 3
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.
-
- Health Maintenance Organization
- Honolulu, HI
- NPI 1710945969
-
dba Richland Parish Hospital Based Physicians
- Critical Access Hospital Clinic/Center
- Delhi, LA
- NPI 1851317911
Internal Medicine
-
dba Richland Parish Hospital Emergency Room Physicians
- Emergency Medicine Physician
- Delhi, LA
- NPI 1760348056
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Honolulu, HI
- NPI 1396813861
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658707200000",
"number": "1215908959",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 MAUI LANI PKWY",
"city": "WAILUKU",
"state": "HI",
"postal_code": "967932416",
"telephone_number": "808-243-6050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 MAUI LANI PKWY",
"city": "WAILUKU",
"state": "HI",
"postal_code": "967932416",
"telephone_number": "808-243-6050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRANDON",
"first_name": "PAUL",
"middle_name": "W.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-31",
"last_updated": "2022-07-25",
"certification_date": "2022-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "HI",
"license": "MD-21227",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "LA",
"license": "017275",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "017275",
"state": "LA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1364738",
"state": "LA"
}
],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/interconnect-prodhim/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "55 Maui Lani Pkwy",
"city": "Wailuku",
"state": "HI",
"country_code": "US",
"postal_code": "967932416",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Wailuku, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.