Individual provider Active NPI

Kyle E. Mouery, MD

  • Family Medicine Physician
  • Lahaina, HI
National Provider Identifier
1699094391
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD-19448 Issued in HI
Practice address
910 Wainee St
Lahaina, HI 96761-1622
Phone
(808) 662-6900
NPI assigned
May 20, 2010
Last updated
Jun 2, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD164064 OR
Student in an Organized Health Care Education/Training Program 390200000X PG151890 OR
Family Medicine Physician 207Q00000X MD-19448 HI Primary

Addresses

Primary practice location

910 Wainee St
Lahaina, HI 96761-1622

Mailing address

910 Wainee St
Lahaina, HI 96761-1622
Phone (808) 662-6900

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/interconnect-prodhim/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

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
I20180329000859 HI Practitioner - Family Practice 4587804299 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Oregon Health Sciences University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hawaii Permanente Medical Group IncGroup PAC ID 7618880667, 705 clinicians

Practice addresses (Care Compare)

2301 Kaanapali Pkwy
Lahaina, HI 96761-1908
Phone (808) 662-6900

3288 Moanalua Rd
Honolulu, HI 96819-1469
Phone (808) 432-0000

55 Maui Lani Pkwy
Wailuku, HI 96793-2416
Phone (808) 243-6050

80 Mahalani St
Wailuku, HI 96793-2531
Phone (808) 243-6000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-19448HIMDFamily Medicine Physician
MD164064ORMDFamily Medicine Physician
PG151890ORMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Hawaii Permanente Medical Group Inc CurrentSince Feb 20, 2018 Accepting new patients

Locations

3288 Moanalua Rd
Honolulu, HI 96819
Phone (808) 265-9205

711 Kapiolani Blvd
Honolulu, HI 96813
Phone (808) 432-5312

2301 Kaanapali Pkwy
Lahaina, HI 96761
Phone (808) 463-4616

910 Wainee St
Lahaina, HI 96761
Phone (808) 243-6000

55 Maui Lani Pkwy
Wailuku, HI 96793
Phone (808) 243-6000

Organizations & group practices 1

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": "1274313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1699094391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 WAINEE ST",
            "city": "LAHAINA",
            "state": "HI",
            "postal_code": "967611622",
            "telephone_number": "808-662-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 WAINEE ST",
            "city": "LAHAINA",
            "state": "HI",
            "postal_code": "967611622",
            "telephone_number": "808-662-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUERY",
        "first_name": "KYLE",
        "middle_name": "E.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-20",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD164064",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OR",
            "license": "PG151890",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "HI",
            "license": "MD-19448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodhim/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "910 Wainee St",
            "city": "Lahaina",
            "state": "HI",
            "country_code": "US",
            "postal_code": "967611622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lahaina, HI

Sources for this page

Verify at the official NPI Registry.