Individual provider Active NPI

Mariam Naomi Fawaz, APRN

  • Women's Health Nurse Practitioner
  • Ewa Beach, HI
National Provider Identifier
1699650481
Registry record updated Aug 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
APRN-5327 Issued in HI
Practice address
91-1082 Kaimalie St Apt 2K3
Ewa Beach, HI 96706-5054
Phone
(865) 441-1721
NPI assigned
Aug 9, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X APRN-5327 HI Primary

Addresses

Primary practice location

91-1082 Kaimalie St Apt 2K3
Ewa Beach, HI 96706-5054

Mailing address

91-1082 Kaimalie St Apt 2K3
Ewa Beach, HI 96706-5054
Phone (865) 441-1721

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
I20260521004098 HI Practitioner - Nurse Practitioner 8921578774 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Tennessee, HSC, College of Medicine, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

86-260 Farrington Hwy
Waianae, HI 96792

86-260 Farrington Hwy
Waianae, HI 96792-3128

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN-5327HIMDWomen's Health Nurse Practitioner

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1754697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754697600000",
    "number": "1699650481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91-1082 KAIMALIE ST APT 2K3",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967065054",
            "telephone_number": "865-441-1721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91-1082 KAIMALIE ST APT 2K3",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967065054",
            "telephone_number": "865-441-1721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAWAZ",
        "first_name": "MARIAM",
        "middle_name": "NAOMI",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-09",
        "last_updated": "2025-08-09",
        "certification_date": "2025-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "HI",
            "license": "APRN-5327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ewa Beach, HI

Sources for this page

Verify at the official NPI Registry.