Organization Active NPI

Ann C Brewer MD Inc

  • Dermatology Physician
  • Makawao, HI
National Provider Identifier
1376280669
Registry record updated Feb 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
ANN C BREWER MD INC
Practice address
30 Kupaoa St # A207
Makawao, HI 96768-6216
Phone
(808) 207-6563
NPI assigned
May 18, 2022
Last updated
Feb 8, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2023

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

Authorized official

Name
Ann Brewer, MDNPI 1235573114
Title
Ceo
Phone
(808) 207-6563

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

30 Kupaoa St # A207
Makawao, HI 96768-6216

Mailing address

30 Kupaoa St # A207
Makawao, HI 96768-6216
Phone (808) 207-6563

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230127001489 HI Part B Supplier - Clinic/Group Practice 7517341167 Receives reassigned benefits from 2 practitioners
Practice locations: Makawao, HI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
12D2278281Ann C Brewer MD Inc Dba Maui Skin Clinic30 Kupaoa St A208, Makawao, HI 96768Provider-performed microscopyMar 13, 2027

National Provider Directory

National Provider Directory

Locations

30 Kupaoa St
#A207
Makawao, HI 96768
Phone (808) 207-6563

30 Kupaoa St
#A208
Makawao, HI 96768
Phone (808) 207-6563

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1652832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675814400000",
    "number": "1376280669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 KUPAOA ST # A207",
            "city": "MAKAWAO",
            "state": "HI",
            "postal_code": "967686216",
            "telephone_number": "808-207-6563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 KUPAOA ST # A207",
            "city": "MAKAWAO",
            "state": "HI",
            "postal_code": "967686216",
            "telephone_number": "808-207-6563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANN C BREWER MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-18",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A",
        "authorized_official_last_name": "BREWER",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "808-207-6563",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Makawao, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.