Individual provider Active NPI

Megan Wade, PA-C

  • Physician Assistant
  • Hilo, HI
National Provider Identifier
1407540339
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
AMD-1279 Issued in HI
Practice address
190 Waianuenue Ave
Hilo, HI 96720
Phone
(808) 932-3000
NPI assigned
Jun 5, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X AMD-1279 HI Primary

Addresses

Primary practice location

190 Waianuenue Ave
Hilo, HI 96720

Mailing address

9627 Red Oakes PL
Highlands Ranch, CO 80126-3586
Phone (802) 349-7093

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230918002085 HI Practitioner - Physician Assistant 9638533144 Reassigns benefits to 2 organizations
I20251002002727 WI Practitioner - Physician Assistant 9638533144 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

400 W River Woods Pkwy
Glendale, WI 53212-1060

5650 Paul Blazer Pkwy
Suite 104
Dublin, OH 43017-3562

Hospital & facility affiliations

  • Ascension All Saints Hospital Hospital, Racine, WI, CCN 520096
  • Ascension Columbia St Marys Hospital Milwaukee Hospital, Milwaukee, WI, CCN 520051

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AMD-1279HIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hilo Benioff Medical Center CurrentSince Aug 30, 2023 Accepting new patients
Kau Hospital CurrentSince Aug 30, 2023 Accepting new patients
Kau Hospital CurrentSince Aug 30, 2023 Accepting new patients
Wisconsin Radiology Specialists, S C Past Accepting new patients

Locations

1190 Waianuenue Ave
Hilo, HI 96720
Phone (808) 932-3000

Organizations & group practices 7

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": "1685923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1407540339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9627 RED OAKES PL",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "801263586",
            "telephone_number": "802-349-7093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 WAIANUENUE AVE",
            "city": "HILO",
            "state": "HI",
            "postal_code": "96720",
            "telephone_number": "808-932-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "MEGAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-05",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "HI",
            "license": "AMD-1279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilo, HI

Sources for this page

Verify at the official NPI Registry.