Homayra Fahmida, APRN
Individual provider Active NPI Family Nurse Practitioner · Koloa, HI
NPI 1467211102 · NPPES record last updated Oct 1, 2024
Key facts
- NPI
- 1467211102
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 11031746 (FL)
- Practice address
- 3958 Kiani St
Koloa, HI 96756-9643 - Phone
- (386) 450-0597
- NPI assigned
- Mar 15, 2024
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Hoola Lahui Hawaii
Practice addresses (Care Compare)
4643 Waimea Canyon Dr
Waimea, HI 96796
Phone (808) 338-1855
PO Box
Suite 487
Waimea, HI 96796
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in FL, HI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240524000748 | FL | Practitioner - Nurse Practitioner | 3779925557 | Reassigns benefits to 1 organization |
| I20250319003870 | HI | Practitioner - Nurse Practitioner | 3779925557 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles (3 of 5)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gastro MD Florida, LLC | Current |
Accepting new patients | |
| Hoola Lahui Hawaii | Current |
Accepting new patients | |
| Hoola Lahui Hawaii | Current |
Accepting new patients |
Locations
929 N Spring Garden Ave
Ste 150
Deland, FL 32720
Phone (386) 339-2692
835 Currency Cir
Ste 1001
Lake Mary, FL 32746
Phone (407) 749-6656
2884 Wellness Ave
Ste 100
Orange City, FL 32763
Phone (386) 668-2221
4800 Kawaihau Rd
Ste D
Kapaa, HI 96746
Phone (808) 240-0170
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/BCJIBA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 11031746 | FL | Yes |
Addresses
Primary practice location
3958 Kiani St
Koloa, HI 96756-9643
Mailing address
3958 Kiani St
Koloa, HI 96756-9643
Phone (386) 450-0597
Other providers in Koloa, HI
- Daniel S Choi MD Professional Corporation
- Frank Joseph Davis
- Edward Franklin De Deo
- Kerry L Dillberg
- Ameen Fayek Elwir
- Diane Faye
- Garden Island Pharmacy Serv, Inc
- Hale Kupuna Heritage Home, LLC
- Healing in Waves Therapy and Wellness LLC
- Molly R Heublein
All providers in Koloa, HI · Family Nurse Practitioner in Hawaii
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 1, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.