Individual provider Active NPI

Krunal S. Patel, DO

  • Nephrology Physician
  • Wailuku, HI
National Provider Identifier
1255909495
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
DOS-2963-0 Issued in HI
Practice address
105 Maui Lani Pkwy Ste 100
Wailuku, HI 96793-2443
Phone
(808) 442-7777
Fax
(808) 442-7778
NPI assigned
Jun 14, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X DOS-2963-0 HI Primary
Internal Medicine Physician 207R00000X DOS-2963-0 HI

Addresses

Primary practice location

105 Maui Lani Pkwy Ste 100
Wailuku, HI 96793-2443

Mailing address

PO Box 3068
Portland, OR 97208-3068
Phone (503) 229-7976

Other identifiers 1

IdentifierTypeStateIssuer
014734MedicaidHI

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260526003334 HI Practitioner - Nephrology 7911303409 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Nova Southeastern College of Osteo Medicine, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1130 NW 22ND Ave
Suite 640
Portland, OR 97210-2993

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LL83610SCMDInternal Medicine Physician
DOS-2963-0HIMDNephrology Physician

Interoperability endpoints

  • Direct secure messaging: kpatel1157955@direct.unc.nchie.net

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1623628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1255909495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3068",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083068",
            "telephone_number": "503-229-7976",
            "fax_number": "503-274-4867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 MAUI LANI PKWY STE 100",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967932443",
            "telephone_number": "808-442-7777",
            "fax_number": "808-442-7778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KRUNAL",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-14",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "HI",
            "license": "DOS-2963-0",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "DOS-2963-0",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014734",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wailuku, HI

Sources for this page

Verify at the official NPI Registry.