Individual provider Active NPI

Cherie L S Raffelson, MD

  • Family Medicine Physician
  • Kapolei, HI
National Provider Identifier
1295836120
Registry record updated May 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD-12435 Issued in HI
Practice address
401 Kamokila Blvd
Kapolei, HI 96707-5607
Phone
(808) 432-3600
NPI assigned
Sep 25, 2006
Last updated
May 25, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD-12435 HI Primary

Addresses

Primary practice location

401 Kamokila Blvd
Kapolei, HI 96707-5607

Mailing address

401 Kamokila Blvd
Kapolei, HI 96707-5607
Phone (808) 432-3600

Other identifiers 2

IdentifierTypeStateIssuer
558413-06MedicaidHI
00A0246510OtherHIHMSA BILLING NUMBER

Other names 1

  • Cherie L Shehata Former name

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, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040522000128 HI Practitioner - Family Practice 3375534852 Reassigns benefits to 1 organization
I20210303002706 CA Practitioner - Family Practice 3375534852 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Hawaii John a. Burns School of Medicine, 2001
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)

3288 Moanalua Rd
Honolulu, HI 96819-1469
Phone (808) 432-0000

401 Kamokila Blvd
Kapolei, HI 96707-5607
Phone (808) 432-3600

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Jan 11, 2021 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Hawaii Permanente Medical Group Inc CurrentSince Nov 23, 2010 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jan 11, 2021 Accepting new patients

Locations

3733 San Dimas St
Ste 101
Bakersfield, CA 93301
Phone (800) 353-5400

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

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

401 Kamokila Blvd
Kapolei, HI 96707
Phone (808) 432-2000

599 Farrington Hwy
Kapolei, HI 96707
Phone (808) 432-3600

94-1480 Moaniani St
Waipahu, HI 96797
Phone (808) 432-2000

Organizations & group practices 4

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": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1295836120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 KAMOKILA BLVD",
            "city": "KAPOLEI",
            "state": "HI",
            "postal_code": "967075607",
            "telephone_number": "808-432-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 KAMOKILA BLVD",
            "city": "KAPOLEI",
            "state": "HI",
            "postal_code": "967075607",
            "telephone_number": "808-432-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAFFELSON",
        "first_name": "CHERIE",
        "middle_name": "L S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "HI",
            "license": "MD-12435",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "558413-06",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA BILLING NUMBER",
            "identifier": "00A0246510",
            "state": "HI"
        }
    ],
    "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": "401 Kamokila Blvd",
            "city": "Kapolei",
            "state": "HI",
            "country_code": "US",
            "postal_code": "967075607",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CHERIE",
            "last_name": "SHEHATA",
            "middle_name": "L",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kapolei, HI

Sources for this page

Verify at the official NPI Registry.