Phylavanh Phanhtharath, ACNS-BC

Primary specialty

Rehabilitation HospitalTaxonomy code 283X00000X

License

AP133384 Issued in TX

Practice address

1190 Waianuenue Ave
Hilo, HI 96720-2094

Phone

(808) 932-3000

NPI assigned

Apr 6, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kau HospitalGroup PAC ID 7416945548, 138 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bayada Home Health Care Home health agency, Hilo, HI, CCN 127312
• Hilo Benioff Medical Center Hospital, Hilo, HI, CCN 120005

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Kau Hospital

  • Rural Health Clinic/Center
  • Pahala, HI
  • NPI 1144304338
  Medicare reassignment Care Compare group NPD
• Hilo Benioff Medical Center

  • General Acute Care Hospital
  • Hilo, HI
  • NPI 1962584060
  Medicare reassignment NPD
• Hilo Benioff Medical Center

  • Anesthesiology Physician
  • Hilo, HI
  • NPI 1235981614
  NPD
• Hilo Benioff Medical Center

  • General Acute Care Hospital
  • Hilo, HI
  • NPI 1780757856
  NPD
• Kau Hospital

  • Rural Health Clinic/Center
  • Pahoa, HI
  • NPI 1285450163
  NPD

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

• B.C.P., Inc.

  • Home Health Agency
  • Hilo, HI
  • NPI 1851650618
  Care Compare affiliation
• Hilo Benioff Medical Center

  • General Acute Care Hospital
  • Hilo, HI
  • NPI 1780757856
  Care Compare affiliation

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

{
    "created_epoch": "1491436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597363200000",
    "number": "1265965321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1190 WAIANUENUE AVE",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967202094",
            "telephone_number": "808-932-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 WAIANUENUE AVE",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967202094",
            "telephone_number": "808-932-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHANHTHARATH",
        "first_name": "PHYLAVANH",
        "name_prefix": "Ms.",
        "credential": "ACNS-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-06",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "HI",
            "license": "APRN-2756",
            "primary": false
        },
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": "TX",
            "license": "AP133384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kori Petsch
• William B Pettis, M.S., L.AC, EMAP
• Daniel Victor Dudley Pettit-Lenz
• Lily Pham, RPH
• Tuan Pham, D.D.S.
• Pharmacy Corporation of America
• Fatima C Phillips, M.D., M.P.H., PH.D.
• Phoenix Center Inc
• Phoenix Center Inc
• Alicia Iwalani Pi

• Rehabilitation Hospital in Hilo, HI
• Providers in Hilo, HI by specialty
• Rehabilitation Hospital in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2020; 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.

Verify at the official NPI Registry.