Individual provider Active NPI

Bryan H Wong, APRN

  • Adult Health Nurse Practitioner
  • Honolulu, HI
National Provider Identifier
1699176263
Registry record updated Sep 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
1712 Issued in HI
Practice address
1301 Punchbowl St
Honolulu, HI 96813-2402
Phone
(808) 538-9011
NPI assigned
Sep 15, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 1712 HI Primary

Addresses

Primary practice location

1301 Punchbowl St
Honolulu, HI 96813-2402

Mailing address

5333 Likini St
Apt 1507
Honolulu, HI 96818-1762
Phone (808) 428-3470

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
I20150121000867 HI Practitioner - Nurse Practitioner 6507180635 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
97.05 of 100Reported as apm
Quality
89.81
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
97.05 of 100Reported as apm
Quality
89.81
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1712HIMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Queens University Medical Group CurrentSince Jun 11, 2023 Accepting new patients
The Queens Medical Center CurrentSince Nov 17, 2014 Accepting new patients
The Queen'S Medical Center CurrentSince Nov 17, 2014 Accepting new patients

Locations

550 S Beretania St
Ste 404
Honolulu, HI 96813
Phone (808) 691-8897

1380 Lusitana St
Ste 913
Honolulu, HI 96813
Phone (808) 691-8521

1301 Punchbowl St
Honolulu, HI 96813
Phone (808) 538-9011

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": "1410739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410739200000",
    "number": "1699176263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5333 LIKINI ST",
            "address_2": "APT 1507",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968181762",
            "telephone_number": "808-428-3470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 PUNCHBOWL ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132402",
            "telephone_number": "808-538-9011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "BRYAN",
        "middle_name": "H",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-15",
        "last_updated": "2014-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "HI",
            "license": "1712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.