Individual provider Active NPI

Aneesh Remani Ravi

  • Psychiatric/Mental Health Nurse Practitioner
  • Ewa Beach, HI
National Provider Identifier
1457952137
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN3078 Issued in HI
Practice address
91-1001 Keaunui Dr Unit 153
Ewa Beach, HI 96706-6328
Phone
(219) 299-0552
NPI assigned
Nov 8, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN3078 HI Primary

Addresses

Primary practice location

91-1001 Keaunui Dr Unit 153
Ewa Beach, HI 96706-6328

Mailing address

91-1001 Keaunui Dr Unit 153
Ewa Beach, HI 96706-6328
Phone (219) 299-0552

Other practice location 1

459 Patterson Rd
Honolulu, HI 96819-1522
Phone (808) 433-0600

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
I20220328000203 HI Practitioner - Nurse Practitioner 5193110211 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Empowerment ResourcesGroup PAC ID 2668710823, 8 clinicians

Practice addresses (Care Compare)

1110 University Ave
Suite 411
Honolulu, HI 96826-1508
Phone (808) 942-7800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN3078HIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Empowerment Resources CurrentSince Dec 16, 2021 Accepting new patients
Hospice Hawaii, Inc. PastSince Jul 17, 2022 Accepting new patients
Hospice Hawaii, Inc. PastSince Nov 1, 2020 Accepting new patients

Locations

1110 University Ave
Ste 411
Honolulu, HI 96826
Phone (808) 942-7800

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1604793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1457952137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91-1001 KEAUNUI DR UNIT 153",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967066328",
            "telephone_number": "219-299-0552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91-1001 KEAUNUI DR UNIT 153",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967066328",
            "telephone_number": "219-299-0552"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "459 Patterson Rd",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968191522",
            "country_code": "US",
            "telephone_number": "808-433-0600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REMANI RAVI",
        "first_name": "ANEESH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-08",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "HI",
            "license": "APRN3078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ewa Beach, HI

Sources for this page

Verify at the official NPI Registry.