Individual provider Active NPI

Kieran Melody, M.D.

  • Surgery Physician
  • Wailuku, HI
National Provider Identifier
1386949709
Registry record updated Aug 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD-26080 Issued in HI
Practice address
80 Mahalani St
Wailuku, HI 96793-2531
Phone
(833) 833-3333
NPI assigned
Jan 14, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD-26080 HI Primary

Addresses

Primary practice location

80 Mahalani St
Wailuku, HI 96793-2531

Mailing address

148 Ka Ikena Loop
Wailuku, HI 96793-4171
Phone (833) 833-3333

Other practice location 1

221 Mahalani St
Wailuku, HI 96793-2526
Phone (808) 244-9056

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20190815000998 WA Practitioner - General Surgery 6204172877 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of California, Davis School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Surgical Associates PLLCGroup PAC ID 5395633572, 8 clinicians

Practice addresses (Care Compare)

3610 Ensign Rd NE
Olympia, WA 98506-5025
Phone (360) 493-5252

Hospital & facility affiliations

  • Providence St Peter Hospital Hospital, Olympia, WA, CCN 500024

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60942255WAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Surgical Associates PLLC CurrentSince Jun 16, 2025 Accepting new patients
Public Hospital District No 2 Skagit County Washington Current Accepting new patients
Public Hospital District No 2 Skagit County Washington CurrentSince Jun 19, 2019 Accepting new patients
Public Hospital District No 2 Skagit County Washington CurrentSince Jun 19, 2019 Accepting new patients
Providence Health & Services Washington Past Accepting new patients
Jefferson County Public Hospital District No 2 PastSince Jun 16, 2025 Accepting new patients

Locations

1211 24th St
Anacortes, WA 98221
Phone (360) 293-3181

1213 24th St
Ste 700
Anacortes, WA 98221
Phone (360) 293-5142

3610 Ensign Rd NE
Olympia, WA 98506
Phone (360) 493-5252

413 Lilly Rd NE
Olympia, WA 98506
Phone (360) 491-9480

Interoperability endpoints

  • Direct secure messaging: kieran.melody.1@9971.direct.athenahealth.com

Organizations & group practices 6

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 2

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": "1294963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786924800000",
    "number": "1386949709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 KA IKENA LOOP",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967934171",
            "telephone_number": "833-833-3333"
        },
        {
            "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": "833-833-3333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "221 Mahalani St",
            "address_purpose": "LOCATION",
            "city": "Wailuku",
            "state": "HI",
            "postal_code": "967932526",
            "country_code": "US",
            "telephone_number": "808-244-9056",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MELODY",
        "first_name": "KIERAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-14",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "HI",
            "license": "MD-26080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wailuku, HI

Sources for this page

Verify at the official NPI Registry.