Individual provider Active NPI

Mish Kuklok, MSN, FNP-BC

  • Family Nurse Practitioner
  • Honolulu, HI
National Provider Identifier
1336578459
Registry record updated Apr 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN 1654 Issued in HI
Practice address
915 N King St
Honolulu, HI 96817-4544
Phone
(808) 848-1438
NPI assigned
Nov 8, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN 1654 HI Primary

Addresses

Primary practice location

915 N King St
Honolulu, HI 96817-4544

Mailing address

915 N King St
Honolulu, HI 96817-4544
Phone (808) 848-1438

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160921002982 HI Practitioner - Nurse Practitioner 3971890765 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kalihi Palama Health CenterGroup PAC ID 4284544842, 28 clinicians

Practice addresses (Care Compare)

915 N King St
Honolulu, HI 96817-4544
Phone (808) 848-1438

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
APRN 1654HIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kalihi Palama Health Center CurrentSince Aug 1, 2016 Accepting new patients
Kalihi Palama Health Center CurrentSince Aug 1, 2016 Accepting new patients

Locations

952 N King St
Honolulu, HI 96817
Phone (808) 841-7981

89 S King St
Fl 3
Honolulu, HI 96813

915 N King St
Honolulu, HI 96817
Phone (808) 848-1438

710 N King St
Honolulu, HI 96817
Phone (808) 843-7500

Interoperability endpoints

  • Direct secure messaging: mish.kuklok.1@28780.direct.athenahealth.com
  • Direct secure messaging: mish.kuklok@hawaiihie.medicity.net

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1383868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429056000000",
    "number": "1336578459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 N KING ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968174544",
            "telephone_number": "808-848-1438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 N KING ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968174544",
            "telephone_number": "808-848-1438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUKLOK",
        "first_name": "MISH",
        "credential": "MSN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-08",
        "last_updated": "2015-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "APRN 1654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.