Shaun P Berry, MD
Individual provider Active NPI Family Medicine Physician · Kailua, HI
NPI 1497725683 · NPPES record last updated Feb 21, 2008
Key facts
- NPI
- 1497725683
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- MD8751 (HI)
- Practice address
- 571 Kaimalino St
Kailua, HI 96734-1611 - Phone
- (808) 387-6868
- Fax
- (808) 254-2346
- NPI assigned
- Jan 23, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD8751 | HI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Veterans Administration Pacific Island Health Care System | Current | Accepting new patients |
Interoperability endpoints
- shaun.berry@hawaiihie.medicity.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD8751 | HI | Yes |
Addresses
Primary practice location
571 Kaimalino St
Kailua, HI 96734-1611
Mailing address
571 Kaimalino St
Kailua, HI 96734-1611
Phone (808) 387-6868
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 07864901 | Medicaid | HI | |
| 07864902 | Medicaid | HI | |
| E207430 | Other | HI | HMSA |
Other providers in Kailua, HI
- Corinne Alyse Bennetts
- Sloane Berger-Chen
- William F. Beringer
- Donna Maria Bernhard
- Gwendolyn Berrisford
- Glenn Todd Bessinger
- Eesha R Bhattacharyya
- Caitlin Elisabeth Bierk
- Joanna Marie Bilancieri
- Joseph E.N. Bird
All providers in Kailua, HI · Family Medicine Physician in Hawaii
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 21, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.