Individual provider Active NPI

Roxanne Haverkort-Yeh

  • Family Nurse Practitioner
  • Honolulu, HI
National Provider Identifier
1629749163
Registry record updated Feb 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN-3359-0 Issued in HI
Practice address
187 Kaeleloi PL
Honolulu, HI 96821-2440
Phone
(808) 278-0578
NPI assigned
Sep 23, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163W00000X RN-92161 HI
Family Nurse Practitioner 363LF0000X APRN-3359-0 HI Primary

Addresses

Primary practice location

187 Kaeleloi PL
Honolulu, HI 96821-2440

Mailing address

932 Ward Ave FL 6
Honolulu, HI 96814-2131
Phone (808) 535-5555

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
I20240820004147 HI Practitioner - Nurse Practitioner 9638617715 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Manakai O Malama IntegrativeGroup PAC ID 4880582808, 9 clinicians

Practice addresses (Care Compare)

677 Ala Moana Blvd
SPC 950
Honolulu, HI 96813-5408
Phone (808) 535-5555

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN-3359-0HIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Manakai O Malama Integrative Multi-Specialty CurrentSince Jun 10, 2024 Accepting new patients

Locations

677 Ala Moana Blvd
Spc 950
Honolulu, HI 96813
Phone (808) 535-5555

932 Ward Ave
Fl 6
Honolulu, HI 96814
Phone (808) 535-5555

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1632355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645660800000",
    "number": "1629749163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "932 WARD AVE FL 6",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968142131",
            "telephone_number": "808-535-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "187 KAELELOI PL",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968212440",
            "telephone_number": "808-278-0578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVERKORT-YEH",
        "first_name": "ROXANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-23",
        "last_updated": "2022-02-24",
        "certification_date": "2021-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": "HI",
            "license": "RN-92161",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "APRN-3359-0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.