Active NPI
Judy Hermosura Canlas
- Adult Care Home Facility
- Waipahu, HI
National Provider Identifier
1538898523
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Care Home Facility
- License
- 1-200077
- Practice address
- 94-534 Hakea PL
Waipahu, HI 96797-4761 - Phone
- (808) 779-6187
- Fax
- (808) 200-5938
- NPI assigned
- Jun 6, 2022
- Last updated
- Jun 7, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Care Home Facility | 311ZA0620X | 1-200077 | HI | Primary |
Addresses
Primary practice location
94-534 Hakea PL
Waipahu, HI 96797-4761
Mailing address
94-534 Hakea PL
Waipahu, HI 96797-4761
Phone (808) 779-6187
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000848 | Medicaid | HI |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Health Information Exchange (HIE) | ||
| CONNECT URL | Health Information Exchange (HIE) |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-200077 | HI | MD | Adult Care Home Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654560000000",
"number": "1538898523",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "94-534 HAKEA PL",
"city": "WAIPAHU",
"state": "HI",
"postal_code": "967974761",
"telephone_number": "808-779-6187",
"fax_number": "808-200-5938"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "94-534 HAKEA PL",
"city": "WAIPAHU",
"state": "HI",
"postal_code": "967974761",
"telephone_number": "808-779-6187",
"fax_number": "808-200-5938"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANLAS",
"first_name": "JUDY",
"middle_name": "HERMOSURA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-06-06",
"last_updated": "2022-06-07",
"certification_date": "2022-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "311ZA0620X",
"taxonomy_group": "",
"desc": "Custodial Care Facility, Adult Care Home",
"state": "HI",
"license": "1-200077",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000848",
"state": "HI"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Email",
"affiliation": "N",
"endpointDescription": "Email",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "94-534 Hakea Pl",
"city": "Waipahu",
"state": "HI",
"country_code": "US",
"postal_code": "967974761",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Email",
"affiliation": "N",
"endpointDescription": "Email",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "94-534 Hakea Pl",
"city": "Waipahu",
"state": "HI",
"country_code": "US",
"postal_code": "967974761",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Waipahu, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.