Individual provider Active NPI

Laura Prado, PA-C

  • Physician Assistant
  • Honolulu, HI
National Provider Identifier
1629602594
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
AMD-1190 Issued in HI
Practice address
1329 Lusitana St Ste 406
Honolulu, HI 96813-2412
Phone
(808) 599-7779
NPI assigned
Feb 28, 2020
Last updated
Feb 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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-1190 HI Primary

Addresses

Primary practice location

1329 Lusitana St Ste 406
Honolulu, HI 96813-2412

Mailing address

1951 SW 172ND Ave Ste 305
Miramar, FL 33029-5614
Phone (954) 362-2720

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
I20230525000667 HI Practitioner - Physician Assistant 5597121012 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Organizations & group practices 1

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": "1582848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1629602594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1951 SW 172ND AVE STE 305",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330295614",
            "telephone_number": "954-362-2720",
            "fax_number": "954-362-2762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1329 LUSITANA ST STE 406",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132412",
            "telephone_number": "808-599-7779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRADO",
        "first_name": "LAURA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-28",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "HI",
            "license": "AMD-1190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.