Individual provider Active NPI

Terri Lee Imada, APRN, ANP-C

  • Adult Health Nurse Practitioner
  • Honolulu, HI
National Provider Identifier
1568672038
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN-345 Issued in HI
Practice address
1907 S Beretania St
Kapiolani Breast Center
Honolulu, HI 96826
Phone
(808) 973-3152
Fax
(808) 973-4762
NPI assigned
May 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X APRN-345 HI Primary

Addresses

Primary practice location

1907 S Beretania St
Kapiolani Breast Center
Honolulu, HI 96826

Mailing address

1907 S Beretania St
Kapiolani Breast Center
Honolulu, HI 96826
Phone (808) 973-3152

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
I20050321000584 HI Practitioner - Nurse Practitioner 3577518711 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Queens Medical CenterGroup PAC ID 3476454067, 191 clinicians

Practice addresses (Care Compare)

1301 Punchbowl St
Honolulu, HI 96813-2499

550 S Beretania St
Honolulu, HI 96813-2496

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.05 of 100Reported as apm
Quality
89.81
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN-345HIMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Queen's Medical Center CurrentSince Nov 16, 2020 Accepting new patients
The Queens Medical Center CurrentSince Nov 16, 2020 Accepting new patients
Liberty Dialysis-Hawaii, LLC Past Accepting new patients

Locations

550 S Beretania St
Ste 404
Honolulu, HI 96813
Phone (808) 691-8897

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

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1568672038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1907 S BERETANIA ST",
            "address_2": "KAPIOLANI BREAST CENTER",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "96826",
            "telephone_number": "808-973-3152",
            "fax_number": "808-973-4762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 S BERETANIA ST",
            "address_2": "KAPIOLANI BREAST CENTER",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "96826",
            "telephone_number": "808-973-3152",
            "fax_number": "808-973-4762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMADA",
        "first_name": "TERRI",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "APRN, ANP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "HI",
            "license": "APRN-345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.