Individual provider Active NPI

Linda M Tetor, MD

  • Family Medicine Physician
  • Kihei, HI
National Provider Identifier
1467450486
Registry record updated Dec 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
18963 Issued in HI
Practice address
221 Piikea Ave Suite a
Kihei, HI 96753-7313
Phone
(808) 874-8100
Fax
(808) 874-6887
NPI assigned
Jul 13, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 18963 HI Primary

Addresses

Primary practice location

221 Piikea Ave Suite a
Kihei, HI 96753-7313

Mailing address

221 Piikea Ave Suite a
Kihei, HI 96753
Phone (808) 874-8100

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
I20170426000612 HI Practitioner - Family Practice 7911039508 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Pennsylvania State University College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kihei-Wailea Medical Center. LLCGroup PAC ID 9739070459, 9 clinicians

Practice addresses (Care Compare)

221 Piikea Ave
Suite a
Kihei, HI 96753-8268
Phone (808) 874-8100

Hospital & facility affiliations

  • Bayada Home Health Care Home health agency, Wailuku, HI, CCN 127309
  • Maui Memorial Medical Center Hospital, Wailuku, HI, CCN 120002

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18963HIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kihei-Wailea Medical Center. LLC CurrentSince Mar 18, 2017 Accepting new patients

Locations

221 Piikea Ave
#A
Wailea, HI 96753
Phone (808) 244-6266

Interoperability endpoints

  • Direct secure messaging: linda.tetor@22487299391492.direct.elationemr.com

Organizations & group practices 1

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": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576022400000",
    "number": "1467450486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 PIIKEA AVE SUITE A",
            "city": "KIHEI",
            "state": "HI",
            "postal_code": "96753",
            "telephone_number": "808-874-8100",
            "fax_number": "808-874-6887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 PIIKEA AVE SUITE A",
            "city": "KIHEI",
            "state": "HI",
            "postal_code": "967537313",
            "telephone_number": "808-874-8100",
            "fax_number": "808-874-6887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TETOR",
        "first_name": "LINDA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-13",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "HI",
            "license": "18963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kihei, HI

Sources for this page

Verify at the official NPI Registry.