Individual provider Active NPI

Carol G. Pham, M.D.

  • Internal Medicine Physician
  • Honolulu, HI
National Provider Identifier
1265793913
Registry record updated May 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
17968 Issued in HI
Practice address
1010 Pensacola St
Honolulu, HI 96814-2118
Phone
(808) 432-2000
NPI assigned
May 30, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 17968 HI Primary

Addresses

Primary practice location

1010 Pensacola St
Honolulu, HI 96814-2118

Mailing address

1010 Pensacola St
Honolulu, HI 96814-2118

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/interconnect-prodhim/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

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
I20151119000330 HI Practitioner - Internal Medicine 0547560823 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Hawaii John a. Burns School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hawaii Permanente Medical Group IncGroup PAC ID 7618880667, 705 clinicians

Practice addresses (Care Compare)

1010 Pensacola St
Honolulu, HI 96814-2118
Phone (808) 432-2000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17968HIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hawaii Permanente Medical Group Inc CurrentSince Oct 10, 2015 Accepting new patients

Locations

3288 Moanalua Rd
Honolulu, HI 96819
Phone (808) 265-9205

711 Kapiolani Blvd
Honolulu, HI 96813
Phone (808) 432-5312

1010 Pensacola St
Honolulu, HI 96814
Phone (808) 432-2000

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1338336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620345600000",
    "number": "1265793913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 PENSACOLA ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968142118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 PENSACOLA ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968142118",
            "telephone_number": "808-432-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "CAROL",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-30",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "17968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodhim/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1010 Pensacola St",
            "city": "Honolulu",
            "state": "HI",
            "country_code": "US",
            "postal_code": "968142118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.