NPIMap

Individual provider Active NPI

Valerie Banjawan Tan, M.D.

  • Nephrology Physician
  • Waipahu, HI
National Provider Identifier
1326371832
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
17453 Issued in HI
Practice address
94-229 Waipahu Depot St Ste 101
Waipahu, HI 96797-3032
Phone
(808) 206-9849
Fax
(808) 206-9850
NPI assigned
Sep 15, 2009
Last updated
Apr 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 17453 HI Primary

Addresses

Primary practice location

94-229 Waipahu Depot St Ste 101
Waipahu, HI 96797-3032

Mailing address

94-229 Waipahu Depot St Ste 101
Waipahu, HI 96797-3032
Phone (808) 206-9849

Other identifiers 2

IdentifierTypeStateIssuer
0000341958OtherHIHMSA (BCBS)
791120MedicaidHI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address vtan33046@direct.acumenmd.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141117000041 HI Practitioner - NephrologyPractitioner - Internal Medicine 4082836606 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hawaii Nephrologists LLCGroup PAC ID 6709007420, 8 clinicians

Practice addresses (Care Compare)

94 -229 Waipahu Depot St
Suite 101
Waipahu, HI 96797-3032
Phone (808) 206-9849

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
80.25
Promoting interoperability
100
Improvement activities
40
Cost
100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17453HIMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hawaii Nephrologists LLC Nephrology CurrentSince Sep 1, 2014 Accepting new patients

Locations

75 Puuhonu Pl
Ste 100
Hilo, HI 96720
Phone (808) 932-3940

75-184 Hualalai Rd
Ste 202
Kailua Kona, HI 96740
Phone (808) 329-8251

94-229 Waipahu Depot St
Ste 101
Waipahu, HI 96797
Phone (808) 206-9849

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.

Hospital & facility affiliations 8

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": "1252972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1326371832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94-229 WAIPAHU DEPOT ST STE 101",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967973032",
            "telephone_number": "808-206-9849",
            "fax_number": "808-206-9850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94-229 WAIPAHU DEPOT ST STE 101",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967973032",
            "telephone_number": "808-206-9849",
            "fax_number": "808-206-9850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "VALERIE",
        "middle_name": "BANJAWAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-15",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "HI",
            "license": "17453",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA (BCBS)",
            "identifier": "0000341958",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "791120",
            "state": "HI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vtan33046@direct.acumenmd.com",
            "affiliation": "N",
            "address_1": "94-229 Waipahu Depot St Ste 101",
            "city": "Waipahu",
            "state": "HI",
            "country_code": "US",
            "postal_code": "967973032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waipahu, HI

Sources for this page

Verify at the official NPI Registry.