Individual provider Active NPI

Kenneth Stephen Ferenchak, MD

  • Pediatrics Physician
  • Waianae, HI
National Provider Identifier
1376179275
Registry record updated Jul 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD-23325-0 Issued in HI
Practice address
86-260 Farrington Hwy
Waianae, HI 96792-3128
Phone
(808) 697-3178
NPI assigned
Mar 23, 2020
Last updated
Jul 14, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ML61057854 WA
Pediatrics Physician 208000000X MD-23325-0 HI Primary

Addresses

Primary practice location

86-260 Farrington Hwy
Waianae, HI 96792-3128

Mailing address

86-260 Farrington Hwy
Waianae, HI 96792-3128
Phone (808) 697-3178

Other practice location 1

4800 Sand Point Way NE # Oc.7830
Seattle, WA 98105-3901
Phone (206) 987-2525

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231013001472 HI Practitioner - Family Practice 2163844820 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD-23325-0HIMDPediatrics Physician
ML61057854WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Waianae District Comprehensive Health and Hospital Board, Inc Pediatrics Current Accepting new patients
Waianae District Comprehensive Health and Hospital Board, Incorporated CurrentSince Sep 18, 2023 Accepting new patients
Waianae District Comprehensive Health and Hospital Board, Incorporated CurrentSince Sep 18, 2023 Accepting new patients

Locations

86-260 Farrington Hwy
Waianae, HI 96792
Phone (808) 696-7081

Interoperability endpoints

  • Direct secure messaging: kenny.ferenchak.p1@direct.wcchc.nextgenshare.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1584921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689292800000",
    "number": "1376179275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86-260 FARRINGTON HWY",
            "city": "WAIANAE",
            "state": "HI",
            "postal_code": "967923128",
            "telephone_number": "808-697-3178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86-260 FARRINGTON HWY",
            "city": "WAIANAE",
            "state": "HI",
            "postal_code": "967923128",
            "telephone_number": "808-697-3178"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4800 Sand Point Way NE # Oc.7830",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981053901",
            "country_code": "US",
            "telephone_number": "206-987-2525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERENCHAK",
        "first_name": "KENNETH",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-23",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "ML61057854",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "HI",
            "license": "MD-23325-0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waianae, HI

Sources for this page

Verify at the official NPI Registry.