Individual provider Active NPI

Kawika Tupuola

  • Physician Assistant
  • St George, UT
National Provider Identifier
1508306168
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1841 E Riverside Dr Ste 201
St George, UT 84790-7061
Phone
(435) 256-8890
Fax
(833) 907-2388
NPI assigned
Mar 1, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Physician Assistant 363A00000X UT Primary

Addresses

Primary practice location

1841 E Riverside Dr Ste 201
St George, UT 84790-7061

Mailing address

6013 S Redwood Rd
Taylorsville, UT 84123-5220
Phone (801) 255-5131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20241007001309 UT Practitioner - Physician Assistant 7911438551 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Utah School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hillside Health PCGroup PAC ID 4688074842, 4 clinicians

Practice addresses (Care Compare)

1841 E Riverside Dr
Suite 201
St George, UT 84790-7061
Phone (435) 256-8890

Hospital & facility affiliations

  • St. George Regional Hospital Hospital, St George, UT, CCN 460021

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Edwards and Edwards PastSince Sep 29, 2024 Accepting new patients

Organizations & group practices 2

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 1

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": "1488326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1508306168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6013 S REDWOOD RD",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841235220",
            "telephone_number": "801-255-5131",
            "fax_number": "801-255-5131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1841 E RIVERSIDE DR STE 201",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847907061",
            "telephone_number": "435-256-8890",
            "fax_number": "833-907-2388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUPUOLA",
        "first_name": "KAWIKA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-01",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

Verify at the official NPI Registry.