Individual provider Active NPI

Maxi L Lohrengel-West, PA

  • Physician Assistant
  • Kihei, HI
National Provider Identifier
1376678565
Registry record updated Oct 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
AMD-512 Issued in HI
Practice address
34 Wailea Gateway PL Ste a-203
Kihei, HI 96753-6525
Phone
(808) 879-1859
NPI assigned
Feb 21, 2007
Last updated
Oct 13, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 56372 CA
Physician Assistant 363A00000X AMD-512 HI Primary

Addresses

Primary practice location

34 Wailea Gateway PL Ste a-203
Kihei, HI 96753-6525

Mailing address

34 Wailea Gateway PL Ste a-203
Kihei, HI 96753-6525
Phone (808) 879-1859

Other practice location 1

16-643 Kipimana St Ste 20
Keaau, HI 96749-8002
Phone (808) 249-9999

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
I20130628000550 HI Practitioner - Physician Assistant 4486797883 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
56372CAMDPharmacist

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": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1376678565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 WAILEA GATEWAY PL STE A-203",
            "city": "KIHEI",
            "state": "HI",
            "postal_code": "967536525",
            "telephone_number": "808-879-1859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 WAILEA GATEWAY PL STE A-203",
            "city": "KIHEI",
            "state": "HI",
            "postal_code": "967536525",
            "telephone_number": "808-879-1859"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16-643 Kipimana St Ste 20",
            "address_purpose": "LOCATION",
            "city": "Keaau",
            "state": "HI",
            "postal_code": "967498002",
            "country_code": "US",
            "telephone_number": "808-249-9999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOHRENGEL-WEST",
        "first_name": "MAXI",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "56372",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "HI",
            "license": "AMD-512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kihei, HI

Sources for this page

Verify at the official NPI Registry.