NPIMap

Organization Active NPI

Duerler, Inc.

Doing business as Mango Medical

  • Family Medicine Physician
  • Kamuela, HI
National Provider Identifier
1376837997
Registry record updated Sep 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DUERLER, INC.
Doing business as
Mango Medical
Practice address
64-1032 Mamalahoa Hwy
Suite 306
Kamuela, HI 96743
Phone
(808) 769-5010
Fax
(808) 769-5208
NPI assigned
May 31, 2011
Last updated
Sep 25, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2015

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

Authorized official

Name
Mr. Timothy Duerler, MDNPI 1053433441
Title
President
Phone
(808) 351-6836

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Public Health & General Preventive Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2083P0901X

Addresses

Primary practice location

64-1032 Mamalahoa Hwy
Suite 306
Kamuela, HI 96743

Mailing address

64-1032 Mamalahoa Hwy
Suite 306
Kamuela, HI 96743
Phone (808) 769-5010

Other names 1

  • Mango Medical Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110721000841 HI Part B Supplier - Clinic/Group Practice 2062680861 Receives reassigned benefits from 17 practitioners
Practice locations: Hilo, HI; Kailua Kona, HI; Kamuela, HI; Makawao, HI; Ocean View, HI; Wailuku, HI
O20180208002142 HI DME Supplier - Multi-Specialty - Physician 2062680861 Practice locations: Kamuela, 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
12D2302206Mango Medical64-1032 Mamalahoa Hwy, Suite 306, Kamuela, HI 96743Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory

Locations

75-5591 Palani Rd
Ste 3002
Kailua Kona, HI 96740
Phone (808) 769-5167

64-1032 Mamalahoa Hwy
Ste 306
Kamuela, HI 96743
Phone (808) 769-5010

1935 Main St
Ste 102
Wailuku, HI 96793
Phone (808) 442-3245

Practitioners & affiliated clinicians

Practitioners 23

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.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1306800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443139200000",
    "number": "1376837997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64-1032 MAMALAHOA HWY",
            "address_2": "SUITE 306",
            "city": "KAMUELA",
            "state": "HI",
            "postal_code": "96743",
            "telephone_number": "808-769-5010",
            "fax_number": "808-769-5208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64-1032 MAMALAHOA HWY",
            "address_2": "SUITE 306",
            "city": "KAMUELA",
            "state": "HI",
            "postal_code": "96743",
            "telephone_number": "808-769-5010",
            "fax_number": "808-769-5208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUERLER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-31",
        "last_updated": "2015-09-25",
        "status": "A",
        "authorized_official_last_name": "DUERLER",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "808-351-6836",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mango Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kamuela, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2015; 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.