Individual provider Active NPI

Lise M. Stevens, MD

  • Pediatrics Physician
  • Lahaina, HI
National Provider Identifier
1386727170
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD-5356 Issued in HI
Practice address
910 Wainee St
Lahaina, HI 96761-1622
Phone
(808) 662-6900
NPI assigned
Oct 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD-5356 HI Primary

Addresses

Primary practice location

910 Wainee St
Lahaina, HI 96761-1622

Mailing address

910 Wainee St
Lahaina, HI 96761-1622
Phone (808) 662-6900

Other identifiers 2

IdentifierTypeStateIssuer
020107-02MedicaidHI
0000022228OtherHIHMSA BILLING NUMBER

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200409000951 HI Practitioner - Pediatric Medicine 6800225061 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Hawaii Permanente Medical Group Inc CurrentSince Feb 22, 2020 Accepting new patients

Locations

711 Kapiolani Blvd
Honolulu, HI 96813
Phone (808) 432-5312

3288 Moanalua Rd
Honolulu, HI 96819
Phone (808) 265-9205

910 Wainee St
Lahaina, HI 96761
Phone (808) 243-6000

55 Maui Lani Pkwy
Wailuku, HI 96793
Phone (808) 243-6000

55 Maui Lani Pkwy
Ofc
Wailuku, HI 96793

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": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1386727170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 WAINEE ST",
            "city": "LAHAINA",
            "state": "HI",
            "postal_code": "967611622",
            "telephone_number": "808-662-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 WAINEE ST",
            "city": "LAHAINA",
            "state": "HI",
            "postal_code": "967611622",
            "telephone_number": "808-662-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "LISE",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "HI",
            "license": "MD-5356",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020107-02",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA BILLING NUMBER",
            "identifier": "0000022228",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lahaina, HI

Sources for this page

Verify at the official NPI Registry.