Individual provider Active NPI

Jezrelle Caras Rafols, NP

  • Family Nurse Practitioner
  • Wailea, HI
National Provider Identifier
1689451759
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN-4238-0 Issued in HI
Practice address
100 Wailea Ike Dr
Wailea, HI 96753-9514
Phone
(808) 281-6580
NPI assigned
Sep 12, 2023
Last updated
Sep 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN-4238-0 HI Primary

Addresses

Primary practice location

100 Wailea Ike Dr
Wailea, HI 96753-9514

Mailing address

100 Wailea Ike Dr
Wailea, HI 96753-9514
Phone (808) 281-6580

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20240828001267 VA Practitioner - Nurse Practitioner 4082153531 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Lifestyle Physicians LLCGroup PAC ID 1951678747, 2 clinicians
Sound Sleep LLCGroup PAC ID 3971914284, 3 clinicians

Practice addresses (Care Compare)

400 Holiday CT
Suite 102
Warrenton, VA 20186-4349
Phone (540) 680-2426

420 Southridge Pkwy
Suite 104
Culpeper, VA 22701-3704
Phone (540) 699-0608

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN-4238-0HIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lifestyle Physicians LLC CurrentSince Jul 1, 2024 Accepting new patients
Sound Sleep LLC CurrentSince Jul 15, 2024 Accepting new patients

Locations

420 Southridge Pkwy
Ste 104
Culpeper, VA 22701
Phone (540) 340-6222

400 Holiday Ct
Ste 102
Warrenton, VA 20186
Phone (540) 680-2426

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1694476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1689451759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WAILEA IKE DR",
            "city": "WAILEA",
            "state": "HI",
            "postal_code": "967539514",
            "telephone_number": "808-281-6580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WAILEA IKE DR",
            "city": "WAILEA",
            "state": "HI",
            "postal_code": "967539514",
            "telephone_number": "808-281-6580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAFOLS",
        "first_name": "JEZRELLE",
        "middle_name": "CARAS",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-12",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "APRN-4238-0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wailea, HI

Sources for this page

Verify at the official NPI Registry.