Individual provider Active NPI

Sydney Kapuamealani Wang, M.S.

  • Speech-Language Pathologist
  • Hilo, HI
National Provider Identifier
1386046910
Registry record updated Dec 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP1661 Issued in HI
Practice address
2148 Awapuhi Street
Hilo, HI 96720-5290
Phone
(808) 365-8128
Fax
(808) 961-6383
NPI assigned
Sep 26, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP1661 HI Primary

Addresses

Primary practice location

2148 Awapuhi Street
Hilo, HI 96720-5290

Mailing address

2148 Awapuhi Street
Hilo, HI 96720-5290
Phone (808) 365-8128

Other identifiers 1

IdentifierTypeStateIssuer
000133MedicaidHI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210218001023 HI Practitioner - Qualified Speech Language Pathologist 6507148970 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wala-Au Therapy LLCGroup PAC ID 9335566413, 2 clinicians

Practice addresses (Care Compare)

2148 Awapuhi St
Hilo, HI 96720-5290
Phone (808) 365-8128

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
23406CAMDProsthodontist
SP1661HIMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Wala-Au Therapy LLC CurrentSince Sep 22, 2020 Accepting new patients

Locations

32 Kinoole St
Ste 110
Hilo, HI 96720
Phone (808) 365-8128

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.

NPI Registry JSON

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

{
    "created_epoch": "1411689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701993600000",
    "number": "1386046910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2148 AWAPUHI STREET",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967205290",
            "telephone_number": "808-365-8128",
            "fax_number": "808-961-6383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2148 AWAPUHI STREET",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967205290",
            "telephone_number": "808-365-8128",
            "fax_number": "808-961-6383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "SYDNEY",
        "middle_name": "KAPUAMEALANI",
        "name_prefix": "Miss",
        "credential": "M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-26",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "HI",
            "license": "SP1661",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000133",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilo, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2023; 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.