Individual provider Active NPI

Naomi Fukuda, APRN-RX, CDE

  • Medical-Surgical Clinical Nurse Specialist
  • Ewa Beach, HI
National Provider Identifier
1629471834
Registry record updated Mar 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical-Surgical Clinical Nurse SpecialistTaxonomy code 364SM0705X
License
APRN-4 Issued in HI
Practice address
91-2135 Fort Weaver Rd
Suite 180
Ewa Beach, HI 96706-3607
Phone
(808) 691-3370
NPI assigned
Oct 1, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diabetes Educator Registered Nurse 163WD0400X RN-26851 HI
Medical-Surgical Clinical Nurse Specialist 364SM0705X APRN-4 HI Primary

Addresses

Primary practice location

91-2135 Fort Weaver Rd
Suite 180
Ewa Beach, HI 96706-3607

Mailing address

91-2135 Fort Weaver Rd
Suite 180
Ewa Beach, HI 96706-3607
Phone (808) 691-3370

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in 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
I20141218000247 HI Practitioner - Other (Non-Physician) 9234452582 Reassigns benefits to 1 organization
I20141230001136 HI Practitioner - Certified Clinical Nurse Specialist (CNS) 9234452582 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Queens Medical CenterGroup PAC ID 3476454067, 191 clinicians

Practice addresses (Care Compare)

550 S Beretania St
Honolulu, HI 96813-2496

91 -2127 Fort Weaver Rd
Ewa Beach, HI 96706-1993

Hospital & facility affiliations

  • The Queens Medical Center Hospital, Honolulu, HI, CCN 120001

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
Certified Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
The Queens Medical Center CurrentSince Oct 7, 2014 Accepting new patients
The Queen'S Medical Center CurrentSince Oct 7, 2014 Accepting new patients

Locations

91-2135 Fort Weaver Rd
Ste 180
Ewa Beach, HI 96706
Phone (808) 675-0400

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

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

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1412121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458691200000",
    "number": "1629471834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91-2135 FORT WEAVER RD",
            "address_2": "SUITE 180",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967063607",
            "telephone_number": "808-691-3370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91-2135 FORT WEAVER RD",
            "address_2": "SUITE 180",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967063607",
            "telephone_number": "808-691-3370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUKUDA",
        "first_name": "NAOMI",
        "credential": "APRN-RX, CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-01",
        "last_updated": "2016-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "HI",
            "license": "RN-26851",
            "primary": false
        },
        {
            "code": "364SM0705X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Medical-Surgical",
            "state": "HI",
            "license": "APRN-4",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ewa Beach, HI

Sources for this page

Verify at the official NPI Registry.