Stephanie Lynn Foltzer, PA-C
Individual provider Active NPI Physician Assistant · Honolulu, HI
NPI 1609217462 · NPPES record last updated Aug 14, 2019
Key facts
- NPI
- 1609217462
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- AMD890 (HI)
- Practice address
- 770 Kapiolani Blvd Ste 705
Honolulu, HI 96813 - Phone
- (808) 597-8799
- NPI assigned
- Jul 9, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Queens University Medical Group
Practice addresses (Care Compare)
1301 Punchbowl St
Honolulu, HI 96813-2499
1380 Lusitana St
Honolulu, HI 96813-2448
Hospital & facility affiliations
- The Queens Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in DC, HI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150827000175 | DC | Practitioner - Physician Assistant | 9638311046 | Reassigns benefits to 1 organization |
| I20190611001873 | HI | Practitioner - Physician Assistant | 9638311046 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AMD890 | HI | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Queens Medical Center | Current |
Accepting new patients | |
| The Queens Medical Center | Current |
Accepting new patients |
Locations
1380 Lusitana St
Ste 913
Honolulu, HI 96813
Phone (808) 691-8521
1301 Punchbowl St
Honolulu, HI 96813
Phone (808) 538-9011
550 S Beretania St
Ste 404
Honolulu, HI 96813
Phone (808) 691-8897
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 25MP00308900 | NJ | |
| Physician Assistant | 363A00000X | AMD890 | HI | Yes |
Addresses
Primary practice location
770 Kapiolani Blvd Ste 705
Honolulu, HI 96813
Mailing address
475 Atkinson Dr Apt 1006
Honolulu, HI 96814-4715
Phone (973) 573-0442
Other providers in Honolulu, HI
- Rebecca Claire Fojas-Calimpong
- Raymond Alexander Folen
- Stephen Thomas Foley
- Hannah-Katherine Brooke Folkers
- Chris Follett
- Fong Eyecare Center, LLC
- Fong Vision Center, Inc.
- Aaron Fong
- Amelia Ann Fong
- Andrew C. O. Fong
All providers in Honolulu, HI · Physician Assistant in Hawaii
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 14, 2019. 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.