Jon Simon Ivey, MD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

MD20823 Issued in HI

Practice address

411 Huku Lii PL Ste 303
Kihei, HI 96753-7062

Phone

(808) 877-7710

NPI assigned

Jul 19, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Ivey Plastic Surgery LLC

  • Plastic Surgery Physician
  • Kihei, HI
  • NPI 1205427861
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1311033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613088000000",
    "number": "1336437797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ATTN: LOCKBOX 5799",
            "address_2": "PO BOX 31000",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968495799",
            "telephone_number": "808-877-7710",
            "fax_number": "808-877-7480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 HUKU LII PL STE 303",
            "city": "KIHEI",
            "state": "HI",
            "postal_code": "967537062",
            "telephone_number": "808-877-7710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVEY",
        "first_name": "JON",
        "middle_name": "SIMON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-19",
        "last_updated": "2021-02-12",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "HI",
            "license": "MD20823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Institute for Antiaging Studies
• Integrated Mental Health Service Inc
• Island Family Surgical Care Center LLC
• Islandhealth.Vip
• Ivey Plastic Surgery LLC
• Terisa Marie Jackson, N.D.
• Arnold Fred Jacobson, MD
• Heidi Janssen, PT
• Kailanamalie Jensen
• Marielis Jepson, PSY.D.

• Plastic Surgery Physician in Kihei, HI
• Providers in Kihei, HI by specialty
• Plastic Surgery Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.