Jerry Takubala Kena, M.B.B.S

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

2060-C Issued in AS

Practice address

PO Box LBJ
Pago Pago, AS 96799-0010

Phone

(684) 633-1222

Fax

(684) 633-2893

NPI assigned

Aug 28, 2013

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

Medicare fee-for-service enrollment

Enrolled in AS

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• American Samoa Medical Center

  • Internal Medicine Physician
  • Pago, AS
  • NPI 1043085681

  AS, Internal Medicine

  Medicare reassignment NPD

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

{
    "created_epoch": "1377648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377648000000",
    "number": "1568896397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX LBJ",
            "city": "PAGO PAGO",
            "state": "AS",
            "postal_code": "967990010",
            "telephone_number": "684-633-1222",
            "fax_number": "684-633-2893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX LBJ",
            "city": "PAGO PAGO",
            "state": "AS",
            "postal_code": "967990010",
            "telephone_number": "684-633-1222",
            "fax_number": "684-633-2893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENA",
        "first_name": "JERRY",
        "middle_name": "TAKUBALA",
        "credential": "M.B.B.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-28",
        "last_updated": "2013-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AS",
            "license": "2060-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Island Link Logistics LLC
• Rodney Londari Itaki, BSCMED, MBBS, MPH
• Jenco Medical Incorporated Dba Samoa Prosthetics Orthotics Company
• Joseph Lescano - Medquest Medical Supply
• Vladimir A Karpukhin, M.D.
• Mikhail Kislitcyn, MD
• Peter E Kolone, PA
• Nikasio Koroi, BDS
• Kamlesh Kumar, M.B.B.S
• Larry Lagatiana, M.B.B.S

• All providers in Pago Pago, AS
• Internal Medicine Physician in American Samoa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2013; 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.

Verify at the official NPI Registry.