Individual provider Active NPI

Eonjung Angeline Kim, MD

  • Neurology Physician
  • Honolulu, HI
National Provider Identifier
1306307905
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
MD-24776 Issued in HI
Practice address
2230 Liliha St Ste 104
Honolulu, HI 96817-7357
Phone
(808) 261-4476
NPI assigned
Mar 27, 2019
Last updated
Dec 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X MD-24776 HI Primary

Addresses

Primary practice location

2230 Liliha St Ste 104
Honolulu, HI 96817-7357

Mailing address

2230 Liliha St Ste 104
Honolulu, HI 96817-7357

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
I20250122000246 HI Practitioner - Neurology 9335470178 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hawaii Pacific Neuroscience LLCGroup PAC ID 8628113453, 8 clinicians

Practice addresses (Care Compare)

2230 Liliha St
Suite 104
Honolulu, HI 96817-1646
Phone (808) 261-4476

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hawaii Pacific Neuroscience LLC Neurology CurrentSince Jan 6, 2025 Accepting new patients

Locations

2230 Liliha St
Ste 104
Honolulu, HI 96817
Phone (808) 261-4476

94-849 Lumiaina St
Unit 203
Waipahu, HI 96797
Phone (808) 261-4476

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DADHAA

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1553644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1306307905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2230 LILIHA ST STE 104",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968177357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2230 LILIHA ST STE 104",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968177357",
            "telephone_number": "808-261-4476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "EONJUNG",
        "middle_name": "ANGELINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-27",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "HI",
            "license": "MD-24776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.