Benjamin M. Delisa, MD
Individual provider Active NPI Obstetrics & Gynecology Physician · Wailuku, HI
NPI 1295930139 · NPPES record last updated Jun 2, 2021
Key facts
- NPI
- 1295930139
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- MD14190 (HI)
- Practice address
- 80 Mahalani St
Wailuku, HI 96793-2531 - Phone
- (808) 243-6150
- NPI assigned
- Jun 20, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Obstetrics/Gynecology
- Education
- University of Connecticut School of Medicine, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Obhg Washington PC
Practice addresses (Care Compare)
12040 NE 128TH St
Kirkland, WA 98034-3013
Phone (864) 908-3530
Hospital & facility affiliations
- Providence Regional Medical Center Everett
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of the uterus | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230123001948 | WA | Practitioner - Obstetrics/Gynecology | 9133212020 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Franciscan Medical Group | Current |
Accepting new patients | |
| King County Public Hospital District No 2 | Current | Accepting new patients | |
| King County Public Hospital District No 2 | Current |
Accepting new patients | |
| Franciscan Medical Group | Current | Accepting new patients | |
| Obhg Washington, PC | Obstetrics & Gynecology | Current |
Accepting new patients |
| Franciscan Medical Group | Current |
Accepting new patients | |
| King County Public Hospital District No. 2 | Current |
Accepting new patients | |
| King County Public Hospital District No. 2 | Past | Accepting new patients |
Locations
1035 116th Ave NE
Bellevue, WA 98004
Phone (425) 451-4141
34515 9th Ave S
Federal Way, WA 98003
Phone (253) 835-8100
34503 9th Ave S
Ste 130
Federal Way, WA 98003
Phone (253) 835-5340
12040 NE 128th St
Kirkland, WA 98034
Phone (425) 899-1000
12040 NE 128th St
#50
Kirkland, WA 98034
Phone (425) 899-1894
1800 NW Myhre Rd
Silverdale, WA 98383
Phone (360) 337-8800
1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200
1717 S J St
Tacoma, WA 98405
Phone (253) 426-4101
1717 S J St
Stop 101
Tacoma, WA 98405
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | MD14190 | HI | Yes |
Addresses
Primary practice location
80 Mahalani St
Wailuku, HI 96793-2531
Mailing address
80 Mahalani St
Wailuku, HI 96793-2531
Phone (808) 243-6150
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 598196-02 | Medicaid | HI | |
| 0000268581 | Other | HI | HMSA BILLING NUMBER |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/interconnect-prodhim/wcf/epic.community.hie/xcpdrespondinggateways | Health Information Exchange (HIE) |
Other providers in Wailuku, HI
- Connie J Debord
- Marada Decker Jr.
- Andrew Deforest
- Angel Mae Del Rosario
- Thomas T. Deleon
- Van Delos Santos
- Dept. of Health-Hawaii-Child and Adolescent Mental Health Division
- Dept. of Health-Hawaii-Developmental Disabilities Division Cmumaui
- Linda L Deramus
- Heather Mills Derrick
All providers in Wailuku, HI · Obstetrics & Gynecology Physician in Hawaii
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 2, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.