Individual provider Active NPI

Clarence Dean Harkness, DPM

  • Podiatrist
  • Hilo, HI
National Provider Identifier
1508917022
Registry record updated Oct 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO170 Issued in HI
Practice address
73 Puuhonu PL RM 105
Hilo, HI 96720-2060
Phone
(808) 961-5700
Fax
(808) 961-5799
NPI assigned
Jan 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X PO170 HI Primary

Addresses

Primary practice location

73 Puuhonu PL RM 105
Hilo, HI 96720-2060

Mailing address

RR 3 Box 1350
Pahoa, HI 96778-7521
Phone (808) 961-5700

Other identifiers 2

IdentifierTypeStateIssuer
0000252197OtherHIHMSA
56938701MedicaidHI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI, SD2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050510001093 HI Practitioner - Podiatry 5698715506 Practice locations: Hilo, HI
I20170731002280 SD Practitioner - Podiatry 5698715506 Practice locations: Custer, SD

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

73 Puuhonu PL
Hilo, HI 96720-2060
Phone (808) 961-5700

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO170HIMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Clarence D Harkness DPM Past Accepting new patients

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349308800000",
    "number": "1508917022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 3 BOX 1350",
            "city": "PAHOA",
            "state": "HI",
            "postal_code": "967787521",
            "telephone_number": "808-961-5700",
            "fax_number": "808-961-5799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 PUUHONU PL RM 105",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967202060",
            "telephone_number": "808-961-5700",
            "fax_number": "808-961-5799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARKNESS",
        "first_name": "CLARENCE",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2012-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "HI",
            "license": "PO170",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "0000252197",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "56938701",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilo, HI

Sources for this page

Verify at the official NPI Registry.