Individual provider Active NPI

Jaryn Iwamoto, APRN

  • Wound Care Registered Nurse
  • Aiea, HI
National Provider Identifier
1679210470
Registry record updated May 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Wound Care Registered NurseTaxonomy code 163WW0000X
License
APRN-3345 Issued in HI
Practice address
98-1079 Moanalua Rd
Aiea, HI 96701-4713
Phone
(808) 485-5414
Fax
(808) 485-3022
NPI assigned
May 13, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Wound Care Registered Nurse 163WW0000X APRN-3345 HI Primary

Addresses

Primary practice location

98-1079 Moanalua Rd
Aiea, HI 96701-4713

Mailing address

98-673 Keikialii St
Aiea, HI 96701
Phone (808) 222-8202

Other names 1

  • Jaryn Lau Former name

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
I20221030000032 HI Practitioner - Nurse Practitioner 9234506551 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
Group practices
Pali Momi Medical CenterGroup PAC ID 6406746916, 90 clinicians

Practice addresses (Care Compare)

98 -1079 Moanalua Rd
Suite 480
Aiea, HI 96701-4723
Phone (808) 488-3400

Hospital & facility affiliations

  • Pali Momi Medical Center Hospital, Aiea, HI, CCN 120026

Merit-based Incentive Payment System (MIPS)

Final score
83.35 of 100Reported as group
Quality
67.49
Promoting interoperability
100
Improvement activities
40
Cost
77

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pali Momi Medical Center CurrentSince Sep 4, 2022 Accepting new patients
Pali Momi Medical Center CurrentSince Sep 4, 2022 Accepting new patients
Skin Kahala LLC Past Accepting new patients

Locations

98-1079 Moanalua Rd
Ste 480
Aiea, HI 96701
Phone (808) 487-8922

98-1079 Moanalua Rd
Ste 680
Aiea, HI 96701
Phone (808) 485-4250

98-1079 Moanalua Rd
Ste 630
Aiea, HI 96701
Phone (808) 485-4250

98-1079 Moanalua Rd
Aiea, HI 96701
Phone (808) 485-4301

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 1

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": "1652400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652400000000",
    "number": "1679210470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98-673 KEIKIALII ST",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "96701",
            "telephone_number": "808-222-8202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98-1079 MOANALUA RD",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967014713",
            "telephone_number": "808-485-5414",
            "fax_number": "808-485-3022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IWAMOTO",
        "first_name": "JARYN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-13",
        "last_updated": "2022-05-13",
        "certification_date": "2022-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": "HI",
            "license": "APRN-3345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JARYN",
            "last_name": "LAU",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Aiea, HI

Sources for this page

Verify at the official NPI Registry.