NPIMap

Individual provider Active NPI

Tricia M. Wahl, PA-C

  • Physician Assistant
  • Honolulu, HI
National Provider Identifier
1497908248
Registry record updated Aug 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
AMD-504 Issued in HI
Practice address
1401 S Beretania St
Suite 250
Honolulu, HI 96814-1870
Phone
(808) 545-2800
Fax
(808) 262-3744
NPI assigned
Oct 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA053666 PA
Physician Assistant 363A00000X AMD-504 HI Primary

Addresses

Primary practice location

1401 S Beretania St
Suite 250
Honolulu, HI 96814-1870

Mailing address

1401 S Beretania St
Suite 250
Honolulu, HI 96814-1870
Phone (808) 545-2800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
AMD-504HIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Past Accepting new patients
Procreate Fertility Center of Virginia PLLC Past Accepting new patients
Advanced Reproductive Medicine and Gynecology of Hawaii, Inc. Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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": "1224806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438992000000",
    "number": "1497908248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 S BERETANIA ST",
            "address_2": "SUITE 250",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968141870",
            "telephone_number": "808-545-2800",
            "fax_number": "808-262-3744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S BERETANIA ST",
            "address_2": "SUITE 250",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968141870",
            "telephone_number": "808-545-2800",
            "fax_number": "808-262-3744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAHL",
        "first_name": "TRICIA",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-24",
        "last_updated": "2015-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA053666",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "HI",
            "license": "AMD-504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.