Individual provider Active NPI

Maria C. Glover, PA-C

  • Family Medicine Physician
  • Kapolei, HI
National Provider Identifier
1376884254
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
AMD-1109 Issued in HI
Practice address
401 Kamokila Blvd
Kapolei, HI 96707-5607
Phone
(808) 432-3600
NPI assigned
Mar 3, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MA055956 PA
Physician Assistant 363A00000X 25MP00302900 NJ
Family Medicine Physician 207Q00000X AMD-1109 HI Primary

Addresses

Primary practice location

401 Kamokila Blvd
Kapolei, HI 96707-5607

Mailing address

401 Kamokila Blvd
Kapolei, HI 96707-5607
Phone (808) 432-3600

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/interconnect-prodhim/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq 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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220727004115 HI Practitioner - Physician Assistant 6305074170 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hawaii Permanente Medical Group IncGroup PAC ID 7618880667, 705 clinicians

Practice addresses (Care Compare)

3288 Moanalua Rd
Honolulu, HI 96819-1469
Phone (808) 432-0000

401 Kamokila Blvd
Kapolei, HI 96707-5607
Phone (808) 432-3600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MP00302900NJMDPhysician Assistant

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": "1362268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1376884254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 KAMOKILA BLVD",
            "city": "KAPOLEI",
            "state": "HI",
            "postal_code": "967075607",
            "telephone_number": "808-432-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 KAMOKILA BLVD",
            "city": "KAPOLEI",
            "state": "HI",
            "postal_code": "967075607",
            "telephone_number": "808-432-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLOVER",
        "first_name": "MARIA",
        "middle_name": "C.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-03",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MA055956",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00302900",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "HI",
            "license": "AMD-1109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodhim/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "401 Kamokila Blvd",
            "city": "Kapolei",
            "state": "HI",
            "country_code": "US",
            "postal_code": "967075607",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kapolei, HI

Sources for this page

Verify at the official NPI Registry.