Individual provider Active NPI

Johanna Au

  • Primary Care Nurse Practitioner
  • Kapolei, HI
National Provider Identifier
1376314732
Registry record updated Jan 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
APRN-4378 Issued in HI
Practice address
599 Farrington Hwy Ste 201
Kapolei, HI 96707-2028
Phone
(808) 691-7338
NPI assigned
Jan 12, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X APRN-4378 HI Primary

Addresses

Primary practice location

599 Farrington Hwy Ste 201
Kapolei, HI 96707-2028

Mailing address

1161 Wainiha St Apt F
Honolulu, HI 96825-2657
Phone (808) 675-8072

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
I20240306001693 HI Practitioner - Nurse Practitioner 7012353667 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Queens University Medical GroupGroup PAC ID 2466831557, 614 clinicians

Practice addresses (Care Compare)

1380 Lusitana St
Honolulu, HI 96813-2448

599 Farrington Hwy
Suite 201
Kapolei, HI 96707-2028
Phone (808) 691-7338

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Queens University Medical Group CurrentSince Feb 22, 2024 Accepting new patients

Locations

1380 Lusitana St
Ste 913
Honolulu, HI 96813
Phone (808) 691-8521

1301 Punchbowl St
Honolulu, HI 96813
Phone (808) 538-9011

599 Farrington Hwy
Ste 201
Kapolei, HI 96707
Phone (808) 674-9500

Organizations & group practices 1

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": "1705017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1376314732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1161 WAINIHA ST APT F",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968252657",
            "telephone_number": "808-675-8072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "599 FARRINGTON HWY STE 201",
            "city": "KAPOLEI",
            "state": "HI",
            "postal_code": "967072028",
            "telephone_number": "808-691-7338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AU",
        "first_name": "JOHANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-12",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "HI",
            "license": "APRN-4378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kapolei, HI

Sources for this page

Verify at the official NPI Registry.