Beau Dylan K Fern, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD-18036 Issued in HI

Practice address

1356 Lusitana St
7TH Floor
Honolulu, HI 96813

Phone

(808) 586-2910

NPI assigned

May 10, 2012

Last updated

Jun 27, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Queens University Medical GroupGroup PAC ID 2466831557, 614 clinicians

Molokai General HospitalGroup PAC ID 2264322874, 13 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The Queens Medical Center Hospital, Honolulu, HI, CCN 120001
• Molokai General Hospital Hospital, Kaunakakai, HI, CCN 121303

Merit-based Incentive Payment System (MIPS)

Final score

97.05 of 100Reported as apm

Quality

89.81

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Molokai General Hospital

  • Critical Access Hospital
  • Kaunakakai, HI
  • NPI 1366486979
  Medicare reassignment Care Compare group NPD
• Queens University Medical Group

  • Multi-Specialty Clinic/Center
  • Honolulu, HI
  • NPI 1891441382
  Medicare reassignment Care Compare group NPD
• The Queen's Medical Center

  • General Acute Care Hospital
  • Honolulu, HI
  • NPI 1487693586
  Medicare reassignment NPD
• Molokai General Hospital

  • Rural Health Clinic/Center
  • Kaunakakai, HI
  • NPI 1235515396
  NPD
• The Queens Medical Center

  • General Acute Care Hospital
  • Honolulu, HI
  • NPI 1184612764
  NPD
• The Queens Medical Center

  dba Queen's Island Urgent Care

  • Urgent Care Clinic/Center
  • Honolulu, HI
  • NPI 1528691383
  NPD
• The Queen's Medical Center

  dba The Queen's Medical Center - West O'ahu

  • General Acute Care Hospital
  • Ewa Beach, HI
  • NPI 1801298708
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Molokai General Hospital

  • Critical Access Hospital
  • Kaunakakai, HI
  • NPI 1366486979
  Care Compare affiliation
• The Queens Medical Center

  • General Acute Care Hospital
  • Honolulu, HI
  • NPI 1184612764
  Care Compare affiliation

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

{
    "created_epoch": "1336608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530057600000",
    "number": "1558620567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91-2141 FORT WEAVER RD",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967061993",
            "telephone_number": "808-691-3190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1356 LUSITANA ST",
            "address_2": "7TH FLOOR",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "96813",
            "telephone_number": "808-586-2910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERN",
        "first_name": "BEAU",
        "middle_name": "DYLAN K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-10",
        "last_updated": "2018-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "MD-18036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary Matthew Ferguson, D.C.
• Kelsie Ferguson
• Valerie Nicole Ferguson, NP
• Antonio M. Feria Jr., DPM
• Heaven Lynne Fermin
• Nicholas S Fern, MBBS
• Clarissa Fernandes
• Ritabelle Fernandes, MD
• Fernandez Sports and Physical Therapy LLC
• Adrianna Christina Fernandez, PA-C

• Internal Medicine Physician in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Internal Medicine Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.