Individual provider Active NPI

Maria Excellsis Dela Cruz, PA-C

  • Physician Assistant
  • Honolulu, HI
National Provider Identifier
1669289898
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
AMD-1420 Issued in HI
Practice address
1401 S Beretania St Ste 102
Honolulu, HI 96814-1871
Phone
(808) 356-5699
NPI assigned
Dec 11, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 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-1420 HI Primary

Addresses

Primary practice location

1401 S Beretania St Ste 102
Honolulu, HI 96814-1871

Mailing address

94-1010 Awanani St
Waipahu, HI 96797-3248
Phone (808) 383-0949

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
I20250320001554 HI Practitioner - Physician Assistant 8325560238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
All Access Ortho Oahu LLCGroup PAC ID 9638618499, 20 clinicians

Practice addresses (Care Compare)

1401 S Beretania St
Honolulu, HI 96814-1871
Phone (808) 356-5699

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AMD-1420HIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ohana Pacific Medical LLC Past Accepting new patients
All Access Ortho LLC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19972/brand/1/csg/1/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1733875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1669289898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94-1010 AWANANI ST",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967973248",
            "telephone_number": "808-383-0949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S BERETANIA ST STE 102",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968141871",
            "telephone_number": "808-356-5699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELA CRUZ",
        "first_name": "MARIA EXCELLSIS",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-11",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "HI",
            "license": "AMD-1420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.