Individual provider Active NPI

Marny Hall-Moriyasu, MSN

  • Adult Health Clinical Nurse Specialist
  • Wailuku, HI
National Provider Identifier
1609258086
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X
License
APRN-3730 Issued in HI
Practice address
85 Maui Lani Pkwy
Wailuku, HI 96793-2416
Phone
(808) 442-5700
NPI assigned
Jun 23, 2015
Last updated
Nov 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Clinical Nurse Specialist 364SA2200X APRN-3730 HI Primary
Diabetes Educator Registered Nurse 163WD0400X 32427 HI

Addresses

Primary practice location

85 Maui Lani Pkwy
Wailuku, HI 96793-2416

Mailing address

16441 Haleakala Hwy
Kula, HI 96790-8023
Phone (808) 283-7951

Other practice location 1

2180 Main St
Wailuku, HI 96793-1625
Phone (808) 242-4214

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
I20220826001439 HI Practitioner - Nurse Practitioner 3971987819 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
32427HIMDDiabetes Educator Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Maui Health System a Kaiser Foundation Hospitals LLC Current Accepting new patients
Maui Health System a Kaiser Foundation Hospitals LLC CurrentSince Nov 14, 2022 Accepting new patients
Maui Health System a Kaiser Foundation Hospitals LLC CurrentSince Nov 14, 2022 Accepting new patients

Locations

221 Mahalani St
Wailuku, HI 96793
Phone (808) 242-2290

85 Maui Lani Pkwy
Wailuku, HI 96793
Phone (808) 442-5700

Interoperability endpoints

  • Direct secure messaging: marny.hall-moriyasu@594277412438020.direct.elationemr.com

Organizations & group practices 3

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": "1435017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1609258086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16441 HALEAKALA HWY",
            "city": "KULA",
            "state": "HI",
            "postal_code": "967908023",
            "telephone_number": "808-283-7951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 MAUI LANI PKWY",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967932416",
            "telephone_number": "808-442-5700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2180 Main St",
            "address_purpose": "LOCATION",
            "city": "Wailuku",
            "state": "HI",
            "postal_code": "967931625",
            "country_code": "US",
            "telephone_number": "808-242-4214",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALL-MORIYASU",
        "first_name": "MARNY",
        "credential": "MSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-23",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "HI",
            "license": "APRN-3730",
            "primary": true
        },
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "HI",
            "license": "32427",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wailuku, HI

Sources for this page

Verify at the official NPI Registry.