Individual provider Active NPI

Elizabeth Kim, M.D.

  • Family Medicine Physician
  • Mililani, HI
National Provider Identifier
1639304124
Registry record updated May 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MDR-5694 Issued in HI
Practice address
95-390 Kuahelani Ave
Mililani, HI 96789-1192
Phone
(808) 627-3230
NPI assigned
May 27, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MDR-5694 HI Primary

Addresses

Primary practice location

95-390 Kuahelani Ave
Mililani, HI 96789-1192

Mailing address

4611 Moho St
Honolulu, HI 96816-5422
Phone (808) 780-4713

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120725001009 HI Practitioner - Family Practice 7113183773 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Straub Clinic and HospitalGroup PAC ID 6305759754, 420 clinicians

Practice addresses (Care Compare)

1100 Ward Ave
Suite 840
Honolulu, HI 96814-1610
Phone (808) 522-4521

888 S King St
Honolulu, HI 96813-3097
Phone (808) 522-4000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MDR-5694HIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Straub Clinic & Hospital CurrentSince Jul 23, 2012 Accepting new patients
Straub Clinic & Hospital CurrentSince Jul 23, 2012 Accepting new patients
Straub Clinic & Hospital Past Accepting new patients

Locations

1100 Ward Ave
Ste 700
Honolulu, HI 96814
Phone (808) 221-8580

888 S King St
Honolulu, HI 96813
Phone (808) 522-4000

Interoperability endpoints

  • Direct secure messaging: elizabeth.kim.1@19917.direct.athenahealth.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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1243382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243382400000",
    "number": "1639304124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4611 MOHO ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968165422",
            "telephone_number": "808-780-4713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95-390 KUAHELANI AVE",
            "city": "MILILANI",
            "state": "HI",
            "postal_code": "967891192",
            "telephone_number": "808-627-3230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "ELIZABETH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-27",
        "last_updated": "2009-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "HI",
            "license": "MDR-5694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mililani, HI

Sources for this page

Verify at the official NPI Registry.