Kelsi M. L. Chan, MD
Individual provider Active NPI Obstetrics & Gynecology Physician · Honolulu, HI
NPI 1336705698 · NPPES record last updated Sep 6, 2023
Key facts
- NPI
- 1336705698
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- MD-23697 (HI)
- Practice address
- 1010 Pensacola St
Honolulu, HI 96814-2118 - Phone
- (808) 432-2000
- NPI assigned
- May 13, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in HI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230918001962 | HI | Practitioner - Obstetrics/Gynecology | 1850755364 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MDR-7726 | HI | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hawaii Permanente Medical Group Inc | Current |
Accepting new patients | |
| Kaiser Foundation Hospitals | Past | Accepting new patients |
Locations
3288 Moanalua Rd
Honolulu, HI 96819
Phone (808) 265-9205
711 Kapiolani Blvd
Honolulu, HI 96813
Phone (808) 432-5312
1010 Pensacola St
Honolulu, HI 96814
Phone (808) 432-2000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | MDR-7726 | HI | |
| Obstetrics & Gynecology Physician | 207V00000X | MD-23697 | HI | Yes |
Addresses
Primary practice location
1010 Pensacola St
Honolulu, HI 96814-2118
Mailing address
1010 Pensacola St
Honolulu, HI 96814-2118
Phone (808) 432-2000
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/interconnect-prodhim/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Health Information Exchange (HIE) |
Other providers in Honolulu, HI
- Gina Chan
- Jenny Kamjun Chan
- Jimmy Cy Chan
- John D Chan
- Ka Yung Karen Chan
- Matthew G. H. Chan
- Nora Mei Yu Chan
- Pon-Sang Chan
- Robyn Jill Chan
- Sean Chan
All providers in Honolulu, HI · Obstetrics & Gynecology Physician in Hawaii
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 6, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.