Individual provider Active NPI

Janice M Montgomery-Suber, FNP

  • Psychiatry Physician
  • Honolulu, HI
National Provider Identifier
1578723300
Registry record updated Nov 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
APRN628 Issued in HI
Practice address
6700 Kalanianaole Hwy Ste 201
Honolulu, HI 96825-1279
Phone
(080) 796-5388
NPI assigned
Jun 16, 2008
Last updated
Nov 18, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN45020 HI
Family Nurse Practitioner 363LF0000X APRN628 HI
Psychiatry Physician 2084P0800X APRN628 HI Primary

Addresses

Primary practice location

6700 Kalanianaole Hwy Ste 201
Honolulu, HI 96825-1279

Mailing address

75 Kaneohe Bay Dr
Kailua, HI 96734-1705
Phone (808) 728-0957

Other practice location 1

75 Kaneohe Bay Dr
Kailua, HI 96734-1705
Phone (808) 728-0957

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
I20040422000548 HI Practitioner - Nurse Practitioner 7719973015 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellness Partners Hawaii IncGroup PAC ID 4183018559, 15 clinicians

Practice addresses (Care Compare)

850 W Hind Dr
Suite 116
Honolulu, HI 96821-1845
Phone (808) 379-6656

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN45020HIMDRegistered Nurse
APRN628HIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness Partners Hawaii Inc CurrentSince May 10, 2022 Accepting new patients
Wellness Partners Hawaii PHP and Iop, LLC CurrentSince Jun 30, 2024 Accepting new patients

Locations

850 W Hind Dr
Ste 116
Honolulu, HI 96821
Phone (808) 379-6656

6700 Kalanianaole Hwy
Ste 201
Honolulu, HI 96825
Phone (808) 264-4915

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668729600000",
    "number": "1578723300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 KANEOHE BAY DR",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967341705",
            "telephone_number": "808-728-0957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6700 KALANIANAOLE HWY STE 201",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968251279",
            "telephone_number": "080-796-5388"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 Kaneohe Bay Dr",
            "address_purpose": "LOCATION",
            "city": "Kailua",
            "state": "HI",
            "postal_code": "967341705",
            "country_code": "US",
            "telephone_number": "808-728-0957",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTGOMERY-SUBER",
        "first_name": "JANICE",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-16",
        "last_updated": "2022-11-18",
        "certification_date": "2022-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "HI",
            "license": "RN45020",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "APRN628",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "HI",
            "license": "APRN628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.