Shane J Millard, AMD

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

AMD 240 Issued in HI

Practice address

130 Kailua Rd
Suite 111
Kailua, HI 96734-3420

Phone

(808) 261-4411

Fax

(808) 466-3354

NPI assigned

Nov 18, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Specialty

Physician Assistant

Education

Other, 2004

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Braun Urgent Care Kailua LLCGroup PAC ID 6901119346, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventist Health Castle Hospital, Kailua, HI, CCN 120006

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: shane.millard@45970684706820.direct.elationemr.com

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.

• Braun Urgent Care Kailua LLC

  • Urgent Care Clinic/Center
  • Kailua, HI
  • NPI 1558753749
  Medicare reassignment Care Compare group Authorized official

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

• Castle Medical Center

  • General Acute Care Hospital
  • Kailua, HI
  • NPI 1316937691
  Care Compare affiliation

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683504000000",
    "number": "1568444941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 KAILUA RD",
            "address_2": "SUITE 111",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967343420",
            "telephone_number": "808-261-4411",
            "fax_number": "808-261-3322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 KAILUA RD",
            "address_2": "SUITE 111",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967343420",
            "telephone_number": "808-261-4411",
            "fax_number": "808-466-3354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLARD",
        "first_name": "SHANE",
        "middle_name": "J",
        "credential": "AMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-18",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "HI",
            "license": "AMD 240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "56774501",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALOHA CARE",
            "identifier": "56774501",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "0000250415",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katlin M Michaels, ATC
• Midpacific Hospitalists LLC
• Stephanie Miear, M.ED
• Sarae Angelina Miguel
• Wayne Russell Millar, D.D.S.
• Chantae M Miller, FNP-BC
• Charity Leigh Miller
• Marian Louise Miller, PSYD
• Vann Miller, CRNA
• Megan Mills, PT, DPT, CERT MDT

• Physician Assistant in Kailua, HI
• Providers in Kailua, HI by specialty
• Physician Assistant in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2023; 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.