Individual provider Active NPI

Dylan S Everett

  • Surgical Physician Assistant
  • Honolulu, HI
National Provider Identifier
1427693266
Registry record updated Oct 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
AMD-960 Issued in HI
Practice address
550 S Beretania St Ste 510
Honolulu, HI 96813-2496
Phone
(808) 691-8086
NPI assigned
Nov 15, 2019
Last updated
Oct 24, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X AMD-960 HI Primary

Addresses

Primary practice location

550 S Beretania St Ste 510
Honolulu, HI 96813-2496

Mailing address

550 S Beretania St Ste 510
Honolulu, HI 96813-2496
Phone (808) 691-8086

Other practice location 1

888 S King St
Honolulu, HI 96813-3097
Phone (808) 522-4000

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
I20200220000219 HI Practitioner - Physician Assistant 7214364892 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Queens University Medical GroupGroup PAC ID 2466831557, 614 clinicians

Practice addresses (Care Compare)

1301 Punchbowl St
Honolulu, HI 96813-2499

1380 Lusitana St
Honolulu, HI 96813-2448

550 S Beretania St
Honolulu, HI 96813-2496

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.05 of 100Reported as apm
Quality
89.81
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AMD-960HIMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Straub Clinic & Hospital CurrentSince Dec 28, 2019 Accepting new patients
Straub Clinic & Hospital CurrentSince Dec 28, 2019 Accepting new patients

Locations

1301 Punchbowl St
Honolulu, HI 96813
Phone (808) 538-9011

888 S King St
Honolulu, HI 96813
Phone (808) 522-4000

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1573776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1427693266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 S BERETANIA ST STE 510",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132496",
            "telephone_number": "808-691-8086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 S BERETANIA ST STE 510",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132496",
            "telephone_number": "808-691-8086"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "888 S King St",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968133097",
            "country_code": "US",
            "telephone_number": "808-522-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVERETT",
        "first_name": "DYLAN",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-15",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "HI",
            "license": "AMD-960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.