Individual provider Active NPI

Kyle Ray Perry, M.D.

  • Emergency Medicine Physician
  • Honolulu, HI
National Provider Identifier
1568626000
Registry record updated Jul 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD16106 Issued in HI
Practice address
1212 Nuuanu Ave Apt 3707
Honolulu, HI 96817-4040
Phone
(808) 631-7732
NPI assigned
Jul 14, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4301092884 MI
Emergency Medicine Physician 207P00000X MD16106 HI Primary

Addresses

Primary practice location

1212 Nuuanu Ave Apt 3707
Honolulu, HI 96817-4040

Mailing address

1212 Nuuanu Ave Apt 3707
Honolulu, HI 96817-4040
Phone (808) 631-7732

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110816000551 HI Practitioner - Emergency Medicine 3779752324 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD16106HIMDEmergency Medicine Physician
4301092884MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Emergency Group, Inc. Emergency Medicine CurrentSince Jul 19, 2011 Accepting new patients

Locations

770 Kapiolani Blvd
Ste 705
Honolulu, HI 96813
Phone (808) 597-8778

1301 Punchbowl St
Honolulu, HI 96813
Phone (808) 538-9011

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1215993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311811200000",
    "number": "1568626000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 NUUANU AVE APT 3707",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968174040",
            "telephone_number": "808-631-7732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 NUUANU AVE APT 3707",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968174040",
            "telephone_number": "808-631-7732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "KYLE",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-14",
        "last_updated": "2011-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301092884",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "HI",
            "license": "MD16106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.