Individual provider Active NPI

Cassandra Lee Crumley, PA

  • Medical Physician Assistant
  • Kailua, HI
National Provider Identifier
1558099838
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
AMD-1216 Issued in HI
Practice address
1015 Aoloa PL Apt 228
Kailua, HI 96734-5207
Phone
(720) 431-2157
NPI assigned
Aug 12, 2022
Last updated
Dec 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X AMD-1216 HI Primary

Addresses

Primary practice location

1015 Aoloa PL Apt 228
Kailua, HI 96734-5207

Mailing address

1015 Aoloa PL Apt 228
Kailua, HI 96734-5207
Phone (720) 431-2157

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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
I20230519001743 HI Practitioner - Physician Assistant 4183080922 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

86-260 Farringtion Hwy
Waianae, HI 96792-3128
Phone (808) 697-3300

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Waianae District Comprehensive Health and Hospital Board, Inc CurrentSince Jan 10, 2025 Accepting new patients
Waianae District Comprehensive Health and Hospital Board, Incorporated CurrentSince Jan 10, 2025 Accepting new patients
Waianae District Comprehensive Health and Hospital Board, Inc Past Accepting new patients

Locations

599 Farrington Hwy
Ste 100
Kapolei, HI 96707
Phone (808) 674-2930

86-260 Farrington Hwy
Waianae, HI 96792
Phone (808) 696-7081

Interoperability endpoints

  • Direct secure messaging: cassandra.crumley.p1@direct.wcchc.nextgenshare.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1660262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1558099838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 AOLOA PL APT 228",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967345207",
            "telephone_number": "720-431-2157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 AOLOA PL APT 228",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967345207",
            "telephone_number": "720-431-2157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUMLEY",
        "first_name": "CASSANDRA",
        "middle_name": "LEE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-12",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "HI",
            "license": "AMD-1216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kailua, HI

Sources for this page

Verify at the official NPI Registry.