Andrew Jacob Van Wieren, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD-22307 Issued in HI

Practice address

1881 Nani St
Wailuku, HI 96793-1811

Phone

(808) 871-7772

NPI assigned

Jun 8, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Specialty

Internal Medicine

Education

Warren Alpert Medical School of Brown University, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hawaii Permanente Medical Group IncGroup PAC ID 7618880667, 705 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kaiser Foundation Hospital Hospital, Honolulu, HI, CCN 120011

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Esperanza Health Centers

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1477812030

  Corporate Officer

  CMS ownership
• Esperanza Health Centers

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1487124707

  W-2 Managing Employee

  CMS ownership
• Esperanza Health Centers

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1669812582

  Corporate Officer

  CMS ownership

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.

• Hawaii Permanente Medical Group Inc

  • Health Maintenance Organization
  • Honolulu, HI
  • NPI 1710945969
  Medicare reassignment Care Compare group NPD
• Community Clinic of Maui, Inc.

  • Community Health Clinic/Center
  • Lahaina, HI
  • NPI 1619721263
  NPD (past)

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

• Kaiser Foundation Hospitals

  • General Acute Care Hospital
  • Honolulu, HI
  • NPI 1396813861
  Care Compare affiliation

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

{
    "created_epoch": "1307491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1639463532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1881 NANI ST",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967931811",
            "telephone_number": "808-871-7772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1881 NANI ST",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967931811",
            "telephone_number": "808-871-7772"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 Francis St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021156110",
            "country_code": "US",
            "telephone_number": "617-732-5500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2001 S California Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606082486",
            "country_code": "US",
            "telephone_number": "773-584-6200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN WIEREN",
        "first_name": "ANDREW",
        "middle_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-08",
        "last_updated": "2022-03-09",
        "certification_date": "2022-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036134500",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "247547",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "MD-22307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha L Uu
• Globalyn Valdez
• Valley Isle Pharmacy
• Valley Isle Pharmacy, Wailuku
• Irminne Gelderloos Van Dyken, MD
• Catherine Vargas
• John R Vaz, MD
• Micah Velasco
• Thomas Anthony Vendetti, PH.D.,LCSW
• Carlin Ventura, PHARMD

• Internal Medicine Physician in Wailuku, HI
• Providers in Wailuku, HI by specialty
• Internal Medicine Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.