Active NPI
Kimble C. Poon, MD
- Cardiovascular Disease Physician
- Wailuku, HI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 15789
- Practice address
- 80 Mahalani St
Wailuku, HI 96793-2531 - Phone
- (808) 243-6000
- Fax
- (000) 000-0000
- NPI assigned
- Jun 13, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Cardiac Electrophysiology Physician | 207RC0001X | 15789 | HI | |
| Cardiovascular Disease Physician | 207RC0000X | 15789 | HI | Primary |
Addresses
Primary practice location
80 Mahalani St
Wailuku, HI 96793-2531
Mailing address
80 Mahalani St
Wailuku, HI 96793-2531
Phone (808) 243-6000
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/interconnect-prodhim/wcf/epic.community.hie/xcpdrespondinggateways | Health Information Exchange (HIE) |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- JS Weill Medical College, Cornell University, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1010 Pensacola St
Honolulu, HI 96814-2118
Phone (808) 432-2000
221 Mahalani St
Wailuku, HI 96793-2526
Phone (808) 244-9056
3288 Moanalua Rd
Honolulu, HI 96819-1469
Phone (808) 432-0000
401 Kamokila Blvd
Kapolei, HI 96707-5607
Phone (808) 432-3600
4366 Kukui Grove St
Suite 101
Lihue, HI 96766-2006
Phone (808) 246-5600
55 Maui Lani Pkwy
Wailuku, HI 96793-2416
Phone (808) 243-6050
67-1185 Mamalahoa Hwy
Kamuela, HI 96743-7304
Phone (808) 881-4500
80 Mahalani St
Wailuku, HI 96793-2531
Phone (808) 243-6000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15789 | HI | MD | Clinical Cardiac Electrophysiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hawaii Permanente Medical Group Inc | Current | Accepting new patients |
Locations
1190 Waianuenue Ave
Hilo, HI 96720
Phone (808) 932-3000
711 Kapiolani Blvd
Honolulu, HI 96813
Phone (808) 432-5312
3288 Moanalua Rd
Honolulu, HI 96819
Phone (808) 265-9205
80 Mahalani St
Wailuku, HI 96793
Phone (808) 243-6000
221 Mahalani St
Wailuku, HI 96793
Phone (808) 242-2290
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.
-
- Health Maintenance Organization
- Honolulu, HI
- NPI 1710945969
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Honolulu, HI
- NPI 1396813861
-
- General Acute Care Hospital
- Wailuku, HI
- NPI 1013379460
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621814400000",
"number": "1376747410",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "80 MAHALANI ST",
"city": "WAILUKU",
"state": "HI",
"postal_code": "967932531",
"telephone_number": "808-243-6000",
"fax_number": "000-000-0000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "80 MAHALANI ST",
"city": "WAILUKU",
"state": "HI",
"postal_code": "967932531",
"telephone_number": "808-243-6000",
"fax_number": "000-000-0000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POON",
"first_name": "KIMBLE",
"middle_name": "C.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-13",
"last_updated": "2021-05-24",
"certification_date": "2021-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
"state": "HI",
"license": "15789",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "HI",
"license": "15789",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/interconnect-prodhim/wcf/epic.community.hie/xcpdrespondinggateways",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "80 Mahalani St",
"city": "Wailuku",
"state": "HI",
"country_code": "US",
"postal_code": "967932531",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Wailuku, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.