Kimberly JD Iese, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3644 Issued in HI

Practice address

500 Ala Moana Blvd Ste 6D
Honolulu, HI 96813-4984

Phone

(808) 777-4000

Fax

(808) 447-0571

NPI assigned

Aug 1, 2007

Last updated

Jun 10, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Kimberly J Defenbaugh Former name

Medicare fee-for-service enrollment

Enrolled in HI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wellness Partners Hawaii IncGroup PAC ID 4183018559, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kimberly.iese@397061318443012.direct.elationemr.com
• Direct secure messaging: kimberly.iese@398015768952836.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.

• Wellness Partners Hawaii Inc

  • Psychiatric/Mental Health Nurse Practitioner
  • Honolulu, HI
  • NPI 1609382340
  Medicare reassignment Care Compare group NPD
• Ekahi Care Management LLC

  • Nurse Practitioner
  • Honolulu, HI
  • NPI 1194144220
  Medicare reassignment NPD
• Wellness Partners Hawaii PHP and Iop, LLC

  • Community/Behavioral Health Agency
  • Honolulu, HI
  • NPI 1033953922
  NPD
• Affiliated Wellness Group LLC

  • Social Worker
  • Pewaukee, WI
  • NPI 1386678423
  NPD (past)

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

{
    "created_epoch": "1185926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591747200000",
    "number": "1285824573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 ALA MOANA BLVD STE 6D",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968134984",
            "telephone_number": "808-777-4000",
            "fax_number": "808-447-0571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 ALA MOANA BLVD STE 6D",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968134984",
            "telephone_number": "808-777-4000",
            "fax_number": "808-447-0571"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1126 S. 70th Street",
            "address_2": "Suite S-507",
            "address_purpose": "LOCATION",
            "city": "West Allis",
            "state": "WI",
            "postal_code": "53214",
            "country_code": "US",
            "telephone_number": "414-727-2789",
            "fax_number": "414-476-8695",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "321 N Kuakini St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968172399",
            "country_code": "US",
            "telephone_number": "808-777-4000",
            "fax_number": "808-447-0571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IESE",
        "first_name": "KIMBERLY",
        "middle_name": "JD",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-01",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7339-123",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "HI",
            "license": "3644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43720500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "DEFENBAUGH",
            "middle_name": "J",
            "credential": "MSW, LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Heidi C Icarangal, RN
• Kimiko Ichikawa
• Megumi Ichiryu, LMHC
• Mary L Ichiyama, APRN, RN, CDE
• Leslie Iczkovitz, LMT
• Kiley Igarashi
• Ruby F Igarashi, APRN., BC.
• Walter Brennan Igawa-Silva, M.D.
• Isaac S Ige, PA C
• Steven Ige

• Clinical Social Worker in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Clinical Social Worker in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.