Lisa K Sodetani, M.D.
Individual provider Active NPI Internal Medicine Physician · Kula, HI
NPI 1609060995 · NPPES record last updated Oct 15, 2024
Key facts
- NPI
- 1609060995
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- MD15783 (HI)
- Practice address
- 100 Keokea PL
Kula, HI 96790-7450 - Phone
- (808) 876-4331
- Fax
- (877) 564-2599
- NPI assigned
- Aug 30, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- University of Southern California Keck School of Medicine, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Hawaii Permanente Medical Group Inc
Practice addresses (Care Compare)
3288 Moanalua Rd
Honolulu, HI 96819-1469
Phone (808) 432-0000
55 Maui Lani Pkwy
Wailuku, HI 96793-2416
Phone (808) 243-6050
Hospital & facility affiliations
- Kaiser Permanente Home Health Agency Maui
- Hospice Maui
- Kaiser Foundation Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in HI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110113000451 | HI | Practitioner - Internal Medicine | 0749479350 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD15783 | HI | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maui Health System a Kaiser Foundation Hospitals LLC | Current |
Accepting new patients | |
| Maui Health System a Kaiser Foundation Hospitals LLC | Current | Accepting new patients | |
| Maui Health System a Kaiser Foundation Hospitals LLC | Current |
Accepting new patients | |
| Hawaii Permanente Medical Group Inc | Current |
Accepting new patients |
Locations
711 Kapiolani Blvd
Honolulu, HI 96813
Phone (808) 432-5312
3288 Moanalua Rd
Honolulu, HI 96819
Phone (808) 265-9205
100 Keokea Pl
Kula, HI 96790
Phone (808) 875-6690
221 Mahalani St
Wailuku, HI 96793
Phone (808) 242-2290
55 Maui Lani Pkwy
Wailuku, HI 96793
Phone (808) 243-6000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD15783 | HI | Yes |
Addresses
Primary practice location
100 Keokea PL
Kula, HI 96790-7450
Mailing address
100 Keokea PL
Kula, HI 96790-7450
Phone (808) 876-4331
Other providers in Kula, HI
- Deanne D Salzer
- Keith William Scherdt
- Michele Scofield
- Tamuz Shiran
- Taylor Lee Smith
- David John Solazzo
- Candle Summers
- Alice C Svoboda
- Casey Terry
- Rochelle Terry
All providers in Kula, HI · Internal Medicine Physician in Hawaii
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 15, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.