Individual provider Active NPI

Hannah Rose Kealohi Moore, PA-C

  • Otolaryngology Physician
  • Hilo, HI
National Provider Identifier
1356114748
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
1213027 Issued in HI
Practice address
1285 Waianuenue Ave
Hilo, HI 96720-1209
Phone
(808) 933-3800
NPI assigned
Nov 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 1213027 HI Primary

Addresses

Primary practice location

1285 Waianuenue Ave
Hilo, HI 96720-1209

Mailing address

1285 Waianuenue Ave
Hilo, HI 96720-1209
Phone (808) 933-3800

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
I20240220003398 HI Practitioner - Physician Assistant 0547604324 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kau HospitalGroup PAC ID 7416945548, 138 clinicians

Practice addresses (Care Compare)

1285 Waianuenue Ave
Hilo, HI 96720-1209
Phone (808) 432-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1213027HIMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kau Hospital CurrentSince Feb 1, 2024 Accepting new patients
Kau Hospital CurrentSince Feb 1, 2024 Accepting new patients

Locations

1285 Waianuenue Ave
Fl 2
Hilo, HI 96720
Phone (808) 932-3940

1285 Waianuenue Ave
#2
Hilo, HI 96720

1285 Waianuenue Ave
Hilo, HI 96720
Phone (808) 932-3878

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": "1699315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1356114748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1285 WAIANUENUE AVE",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967201209",
            "telephone_number": "808-933-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1285 WAIANUENUE AVE",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967201209",
            "telephone_number": "808-933-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "HANNAH",
        "middle_name": "ROSE KEALOHI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-07",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "HI",
            "license": "1213027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilo, HI

Sources for this page

Verify at the official NPI Registry.