Active NPI
Michael Stettner, PA
- Medical Physician Assistant
- Honolulu, HI
National Provider Identifier
1336198530
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA13684
- Practice address
- 888 S King St
Honolulu, HI 96813-3009 - Phone
- (808) 522-4000
- NPI assigned
- May 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA13684 | CA | Primary |
| Physician Assistant | 363A00000X | AMD-214 | HI |
Addresses
Primary practice location
888 S King St
Honolulu, HI 96813-3009
Mailing address
1946 Young St
Suite 360
Honolulu, HI 96826-2150
Phone (808) 973-7320
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PA13684 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13684 | CA | MD | Addiction (Substance Use Disorder) Counselor |
| PA13684 | CA | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Berkeley Emergency Medical Group, Inc. | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Emergency Medicine Physician
- Berkeley, CA
- NPI 1780692632
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204156800000",
"number": "1336198530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1946 YOUNG ST",
"address_2": "SUITE 360",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968262150",
"telephone_number": "808-973-7320",
"fax_number": "808-973-7325"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "888 S KING ST",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968133009",
"telephone_number": "808-522-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STETTNER",
"first_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-08",
"last_updated": "2008-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CA",
"license": "PA13684",
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "HI",
"license": "AMD-214",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PA13684",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Honolulu, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.