Individual provider Active NPI

Alexandra Ditullio, M.D.

  • Emergency Medicine Physician
  • Honolulu, HI
National Provider Identifier
1710243886
Registry record updated Dec 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
18042 Issued in HI
Practice address
770 Kapiolani Blvd
Suite 705
Honolulu, HI 96813-5212
Phone
(808) 597-8778
NPI assigned
Apr 3, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 18042 HI Primary

Addresses

Primary practice location

770 Kapiolani Blvd
Suite 705
Honolulu, HI 96813-5212

Mailing address

770 Kapiolani Blvd
Suite 705
Honolulu, HI 96813-5212
Phone (808) 597-8778

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
I20151013001052 HI Practitioner - Emergency Medicine 1052620135 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ac Med LLCGroup PAC ID 4587039441, 4 clinicians

Practice addresses (Care Compare)

73 -4976 Kamanu St
Suite 110
Kailua Kona, HI 96740-2694
Phone (808) 300-3441

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18042HIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Queens North Hawaii Community Hospital CurrentSince Aug 31, 2019 Accepting new patients
MF Med Inc CurrentSince Apr 1, 2021 Accepting new patients
Ac Med LLC. CurrentSince Nov 2, 2022 Accepting new patients
Aloha Wound Care Group LLC CurrentSince Apr 1, 2019 Accepting new patients
North Hawaii Community Hospital, Inc. CurrentSince Aug 31, 2019 Accepting new patients
Hawaii Emergency Physicians Associated Inc Emergency Medicine CurrentSince Apr 1, 2021 Accepting new patients
Midpacific Hospitalists LLC Past Accepting new patients

Locations

1190 Waianuenue Ave
Hilo, HI 96720
Phone (808) 932-3000

45-547 Plumeria St
Honokaa, HI 96727
Phone (808) 775-7211

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

56-117 Pualalea St
Kahuku, HI 96731
Phone (808) 293-9221

640 Ulukahiki St
Kailua, HI 96734
Phone (808) 261-3326

75-184 Hualalai Rd
Ste 302
Kailua Kona, HI 96740
Phone (808) 329-0111

73-4976 Kamanu St
Ste 110
Kailua Kona, HI 96740
Phone (808) 300-3441

67-1125 Mamalahoa Hwy
Kamuela, HI 96743
Phone (808) 881-4400

79-1019 Haukapila St
Kealakekua, HI 96750
Phone (808) 322-4413

100 Kahelu Ave
Ste 105
Mililani, HI 96789
Phone (808) 329-0111

Interoperability endpoints

  • Direct secure messaging: alexandra.ditullio@hawaiihie.medicity.net
  • Direct secure messaging: alexandra.ditullio@20467783892996.direct.elationemr.com

Organizations & group practices 7

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": "1333411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449792000000",
    "number": "1710243886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 KAPIOLANI BLVD",
            "address_2": "SUITE 705",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968135212",
            "telephone_number": "808-597-8778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 KAPIOLANI BLVD",
            "address_2": "SUITE 705",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968135212",
            "telephone_number": "808-597-8778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DITULLIO",
        "first_name": "ALEXANDRA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-03",
        "last_updated": "2015-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "HI",
            "license": "18042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.