Active NPI
Wesam Agha, DO
- Internal Medicine Physician
- Kealakekua, HI
National Provider Identifier
1700273554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- DOS-1988
- Practice address
- 79-1019 Haukapila St
Kealakekua, HI 96750-7920 - Phone
- (808) 322-9311
- NPI assigned
- Apr 20, 2015
- Last updated
- May 19, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 1988 | HI | |
| Internal Medicine Physician | 207R00000X | DOS-1988 | HI | Primary |
Addresses
Primary practice location
79-1019 Haukapila St
Kealakekua, HI 96750-7920
Mailing address
77-6431 Kilohana St
Kailua Kona, HI 96740-7900
Phone (703) 946-6120
Other practice location 1
5450 Fort St
Trenton, MI 48183-4601
Phone (703) 946-6120
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | None | ||
| Other URL | None |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Hospitalist
- Education
- Michigan State University College of Human Medicine, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
79 -1019 Haukapila St
Kealakekua, HI 96750-7920
Phone (808) 322-9311
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1988 | HI | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kauai Medical Clinic | Current | Accepting new patients | |
| Sound Physicians of Hawaii Inc | Internal Medicine | Current | Accepting new patients |
| Kauai Medical Clinic | Current | Accepting new patients | |
| Kona Hospital | Past | Accepting new patients |
Locations
79-1019 Haukapila St
Kealakekua, HI 96750
Phone (808) 322-4413
3-3420 Kuhio Hwy
Ste B
Lihue, HI 96766
Phone (808) 245-1500
3-3420 Kuhio Hwy
Ste B
Lihue, HI 96766
Phone (808) 245-1500
Organizations & group practices 4
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.
-
- Internal Medicine Physician
- Kealakekua, HI
- NPI 1740658053
-
- Multi-Specialty Clinic/Center
- Lihue, HI
- NPI 1376596643
-
- Durable Medical Equipment & Medical Supplies
- Koloa, HI
- NPI 1871611558
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": "1429488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621382400000",
"number": "1700273554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "77-6431 KILOHANA ST",
"city": "KAILUA KONA",
"state": "HI",
"postal_code": "967407900",
"telephone_number": "703-946-6120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "79-1019 HAUKAPILA ST",
"city": "KEALAKEKUA",
"state": "HI",
"postal_code": "967507920",
"telephone_number": "808-322-9311"
}
],
"practiceLocations": [
{
"address_1": "5450 Fort St",
"address_purpose": "LOCATION",
"city": "Trenton",
"state": "MI",
"postal_code": "481834601",
"country_code": "US",
"telephone_number": "703-946-6120",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "AGHA",
"first_name": "WESAM",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-20",
"last_updated": "2021-05-19",
"certification_date": "2021-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "HI",
"license": "1988",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "HI",
"license": "DOS-1988",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "None",
"affiliation": "N",
"address_1": "79-1019 Haukapila St",
"city": "Kealakekua",
"state": "HI",
"country_code": "US",
"postal_code": "967507920",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "None",
"affiliation": "N",
"address_1": "79-1019 Haukapila St",
"city": "Kealakekua",
"state": "HI",
"country_code": "US",
"postal_code": "967507920",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Kealakekua, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.