Individual provider Active NPI

Lindsey Ella Heathcock, MD

  • Pediatrics Physician
  • Honolulu, HI
National Provider Identifier
1457840563
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD21734 Issued in HI
Practice address
1319 Punahou St
Honolulu, HI 96826
Phone
(808) 983-8641
NPI assigned
May 3, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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 MD21734 HI Primary

Addresses

Primary practice location

1319 Punahou St
Honolulu, HI 96826

Mailing address

1319 Punahou St
Honolulu, HI 96826-1001
Phone (808) 983-8641

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
I20221026000631 HI Practitioner - Pediatric Medicine 8123494549 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD21734HIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kapiolani Medical Center for Women & Children CurrentSince Jul 1, 2021 Accepting new patients
Kapiolani Medical Center for Women & Children CurrentSince Jul 1, 2021 Accepting new patients
Kapiolani Medical Specialists CurrentSince Jul 1, 2021 Accepting new patients
Kapiolani Medical Center Past Accepting new patients
Kapiolani Medical Center for Women & Children Past Accepting new patients

Locations

55 Merchant St
Fl 22
Honolulu, HI 96813
Phone (808) 535-7600

1319 Punahou St
Honolulu, HI 96826
Phone (808) 485-4300

Organizations & group practices 5

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": "1525305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1457840563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1319 PUNAHOU ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968261001",
            "telephone_number": "808-983-8641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1319 PUNAHOU ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "96826",
            "telephone_number": "808-983-8641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEATHCOCK",
        "first_name": "LINDSEY",
        "middle_name": "ELLA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-03",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "HI",
            "license": "MD21734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.