Individual provider Active NPI

Reece Goo

  • Physician Assistant
  • Honolulu, HI
National Provider Identifier
1356072979
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1303 Issued in HI
Practice address
321 N Kuakini St Ste 714
Honolulu, HI 96817-2362
Phone
(808) 528-3606
NPI assigned
Jun 23, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 1303 HI Primary

Addresses

Primary practice location

321 N Kuakini St Ste 714
Honolulu, HI 96817-2362

Mailing address

321 N Kuakini St Ste 714
Honolulu, HI 96817-2362
Phone (808) 528-3606

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
I20240514003975 HI Practitioner - Physician Assistant 2062853591 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aloha Gastroenterology LLCGroup PAC ID 8729428149, 2 clinicians

Practice addresses (Care Compare)

321 N Kuakini St
Suite 714
Honolulu, HI 96817-2362
Phone (808) 528-3606

Hospital & facility affiliations

  • Kuakini Medical Center Hospital, Honolulu, HI, CCN 120007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1303HIMDOrthodontics and Dentofacial Orthopedic Dentist

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.

Hospital & facility affiliations 1

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": "1655942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1356072979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 N KUAKINI ST STE 714",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968172362",
            "telephone_number": "808-528-3606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 N KUAKINI ST STE 714",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968172362",
            "telephone_number": "808-528-3606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOO",
        "first_name": "REECE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-23",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "HI",
            "license": "1303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.