Active NPI
Jeffrey Mank, PA-C
- Physician Assistant
- Aiea, HI
National Provider Identifier
1568200814
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- AMD-1382
- Practice address
- 99-128 Aiea Heights Dr Ste 401
Aiea, HI 96701-3934 - Phone
- (808) 488-3000
- NPI assigned
- Jul 19, 2024
- Last updated
- Jul 19, 2024
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | AMD-1382 | HI | Primary |
Addresses
Primary practice location
99-128 Aiea Heights Dr Ste 401
Aiea, HI 96701-3934
Mailing address
91-1029 Kaihawanawana St
Ewa Beach, HI 96706-5024
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AMD-1382 | HI | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1721347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721347200000",
"number": "1568200814",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "91-1029 KAIHAWANAWANA ST",
"city": "EWA BEACH",
"state": "HI",
"postal_code": "967065024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "99-128 AIEA HEIGHTS DR STE 401",
"city": "AIEA",
"state": "HI",
"postal_code": "967013934",
"telephone_number": "808-488-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANK",
"first_name": "JEFFREY",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-07-19",
"last_updated": "2024-07-19",
"certification_date": "2024-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "HI",
"license": "AMD-1382",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aiea, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.