Individual provider Active NPI

Kenneth Martin, PA-C

  • Physician Assistant
  • Honolulu, HI
National Provider Identifier
1598064677
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
AMD-508 Issued in HI
Practice address
1401 S Beretania St Ste 750
Honolulu, HI 96814-1881
Phone
(808) 686-4010
NPI assigned
Mar 15, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X AMD-508 HI Primary

Addresses

Primary practice location

1401 S Beretania St Ste 750
Honolulu, HI 96814-1881

Mailing address

1401 S Beretania St Ste 750
Honolulu, HI 96814-1881
Phone (808) 686-4010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, HI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110803000098 MA Practitioner - Physician Assistant 4981873205 Reassigns benefits to 4 organizations
I20130709000697 HI Practitioner - Physician Assistant 4981873205 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Queens University Medical GroupGroup PAC ID 2466831557, 614 clinicians

Practice addresses (Care Compare)

1380 Lusitana St
Honolulu, HI 96813-2448

1401 S Beretania St
Suite 750
Honolulu, HI 96814-1881
Phone (808) 691-8526

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
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Queen'S Medical Center CurrentSince Dec 8, 2023 Accepting new patients
The Queens Medical Center CurrentSince Dec 8, 2023 Accepting new patients
Medical Affiliates of Cape Cod, Inc. CurrentSince Mar 26, 2017 Accepting new patients
Orthopedic Services Company, LLP CurrentSince Oct 1, 2019 Accepting new patients

Locations

670 Ponahawai St
Ste 122
Hilo, HI 96720
Phone (808) 521-2712

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

1301 Punchbowl St
Lbby
Honolulu, HI 96813

1401 S Beretania St
Ste 750
Honolulu, HI 96814
Phone (808) 521-8183

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

100 Ter Heun Dr
Falmouth, MA 02540
Phone (508) 457-3501

27 Park St
Hyannis, MA 02601
Phone (508) 775-5011

25 Communication Way
Hyannis, MA 02601
Phone (508) 957-8669

Organizations & group practices 10

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": "1300147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1598064677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 S BERETANIA ST STE 750",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968141881",
            "telephone_number": "808-686-4010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S BERETANIA ST STE 750",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968141881",
            "telephone_number": "808-686-4010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "KENNETH",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-15",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "HI",
            "license": "AMD-508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.