Individual provider Active NPI

Ilya Vladimir Yepishin, D.O.

  • Family Medicine Physician
  • Honolulu, HI
National Provider Identifier
1275893109
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DOS-1673 Issued in HI
Practice address
459 Patterson Rd
Honolulu, HI 96819-1522
Phone
(808) 214-1306
Fax
(844) 656-5581
NPI assigned
May 25, 2012
Last updated
Mar 21, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X DOS-1673 HI Primary
Geriatric Medicine (Family Medicine) Physician 207QG0300X DOS-1673 HI

Addresses

Primary practice location

459 Patterson Rd
Honolulu, HI 96819-1522

Mailing address

459 Patterson Rd
Honolulu, HI 96819-1522
Phone (808) 214-1306

Other practice location 1

640 Ulukahiki St
Kailua, HI 96734-4454
Phone (808) 263-5500

Other practice location 2

3238 Esther St
Honolulu, HI 96815-4132
Phone (310) 408-2891

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
I20160829002305 HI Practitioner - Geriatric MedicinePractitioner - Family Practice 3971898842 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Geriatric Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midpacific Hospitalists LLCGroup PAC ID 9335439926, 12 clinicians
Inpatient Medicine Services LLCGroup PAC ID 5890833313, 10 clinicians

Practice addresses (Care Compare)

128 Lehua St
Wahiawa, HI 96786-2036
Phone (808) 621-3326

640 Ulukahiki St
Kailua, HI 96734-4454
Phone (808) 263-5500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
92.5
Improvement activities
40
Cost
94.4

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Medicine Services LLC CurrentSince Aug 1, 2019 Accepting new patients
Midpacific Hospitalists LLC CurrentSince Oct 1, 2017 Accepting new patients
Molokai General Hospital Current Accepting new patients
Hawaii Permanente Medical Group Inc CurrentSince Feb 12, 2024 Accepting new patients
Queens North Hawaii Community Hospital Past Accepting new patients
Hawaii Emergency Physicians Associated Inc Past Accepting new patients

Locations

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

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

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

640 Ulukahiki St
Kailua, HI 96734
Phone (808) 261-3326

67-1125 Mamalahoa Hwy
Kamuela, HI 96743
Phone (808) 881-4400

128 Lehua St
Wahiawa, HI 96786
Phone (808) 621-4330

Organizations & group practices 6

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.

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": "1337904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1275893109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "459 PATTERSON RD",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968191522",
            "telephone_number": "808-214-1306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "459 PATTERSON RD",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968191522",
            "telephone_number": "808-214-1306",
            "fax_number": "844-656-5581"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "640 Ulukahiki St",
            "address_purpose": "LOCATION",
            "city": "Kailua",
            "state": "HI",
            "postal_code": "967344454",
            "country_code": "US",
            "telephone_number": "808-263-5500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3238 Esther St",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968154132",
            "country_code": "US",
            "telephone_number": "310-408-2891",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YEPISHIN",
        "first_name": "ILYA",
        "middle_name": "VLADIMIR",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-25",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "HI",
            "license": "DOS-1673",
            "primary": true
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "HI",
            "license": "DOS-1673",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.