Mark G Schultz, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN-3257 Issued in HI

Practice address

16-590 Old Volcano Rd Ste B
Keaau, HI 96749-8158

Phone

(808) 333-3450

Fax

(808) 930-4721

NPI assigned

Mar 28, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, HI2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mark.schultz.1@23277.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 and National Provider Directory roles.

• Southeast Alaska Regional Health Consortium

  • Clinic/Center
  • Thorne Bay, AK
  • NPI 1376758037

  TX

  Medicare reassignment NPD
• Yakutat Tribal Health Board

  • Clinic/Center
  • Yakutat, AK
  • NPI 1871529628

  TX

  Medicare reassignment NPD
• Southeast Alaska Regional Health Consortium

  • Clinic/Center
  • Juneau, AK
  • NPI 1427941343
  NPD
• Southeast Alaska Regional Health Consortium

  • Critical Access Hospital
  • Sitka, AK
  • NPI 1720062524
  NPD
• Michael B. Russo, MD, Inc

  • Specialist
  • Honolulu, HI
  • NPI 1588957500
  NPD (past)
• Project Vision Hawaii

  • Family Nurse Practitioner
  • Honolulu, HI
  • NPI 1629534268
  NPD (past)

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

{
    "created_epoch": "1301270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1235438433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15-2817 PAPAI ST",
            "city": "PAHOA",
            "state": "HI",
            "postal_code": "967788548",
            "telephone_number": "808-769-2373",
            "fax_number": "808-930-4721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16-590 OLD VOLCANO RD STE B",
            "city": "KEAAU",
            "state": "HI",
            "postal_code": "967498158",
            "telephone_number": "808-333-3450",
            "fax_number": "808-930-4721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULTZ",
        "first_name": "MARK",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-28",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "1157",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "60133272",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "APRN-3257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsay Ellice Sanchez, APRN
• Ydine Elena Sandberg, MA. SLP-CCC
• Jasmyne Sato, RPH
• Jose Aurelio Saucedo, ATC
• Alicia Renee Schillewaert
• Katrina A Scott, LPN
• Courtney Sen
• Jacqueline Shea
• Ned Ken Shimabukuro, PT
• Gage Sigman

• Family Nurse Practitioner in Keaau, HI
• Providers in Keaau, 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 Dec 18, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.