Kelsie Tada

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

AMD-654 Issued in HI

Practice address

500 Ala Moana Blvd Ste 1-302
Honolulu, HI 96813-4925

Phone

(808) 528-3657

Fax

(808) 524-6552

NPI assigned

Oct 7, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Honolulu Pain Management Clinic, L.L.C.Group PAC ID 8123919537, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: kelsie.look@37389611368452.direct.elationemr.com

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.

• Honolulu Pain Management Clinic, L.L.C.

  • Pain Medicine (Anesthesiology) Physician
  • Honolulu, HI
  • NPI 1912057100
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1444176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1275904930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 ALA MOANA BLVD STE 1-302",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968134925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 ALA MOANA BLVD STE 1-302",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968134925",
            "telephone_number": "808-528-3657",
            "fax_number": "808-524-6552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TADA",
        "first_name": "KELSIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-07",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "HI",
            "license": "AMD-654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06819901",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Naomi Tachera
• Yukako Tachibana, M.D.
• Loren Tacker
• Bert Chiyotano Tada, PT
• Dayle Mari Tada, OTR
• Kendall Tada, DDS, MS
• Troy Alan Tada, D.O
• Carl Joseph Tadaki, M.D.
• Stella W. Tadaki, MD
• Wayne Tadaki, R.P.T.

• Medical Physician Assistant in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Medical Physician Assistant in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; 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.