Kourt Bacon, DO

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

0102206358 Issued in VA

Practice address

1 Jarrett White Rd
Tripler Army Medical Center, HI 96859-5001

Phone

(971) 732-3174

NPI assigned

Apr 4, 2019

Last updated

Jul 11, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Anesthesiology

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kauai Medical ClinicGroup PAC ID 5092628479, 147 clinicians

Straub Clinic and HospitalGroup PAC ID 6305759754, 420 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wilcox Memorial Hospital Hospital, Lihue, HI, CCN 120014
• Straub Clinic and Hospital Hospital, Honolulu, HI, CCN 120022

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Kauai Medical Clinic

  • Multi-Specialty Clinic/Center
  • Lihue, HI
  • NPI 1376596643
  Medicare reassignment Care Compare group NPD
• Straub Clinic & Hospital

  dba Straub Benioff Medical Center

  • Multi-Specialty Clinic/Center
  • Honolulu, HI
  • NPI 1457306508
  Medicare reassignment Care Compare group NPD
• Island Medical Consultants, LLC

  • Anesthesiology Physician
  • Honolulu, HI
  • NPI 1881965986
  Medicare reassignment NPD
• Kauai Medical Clinic

  • Durable Medical Equipment & Medical Supplies
  • Koloa, HI
  • NPI 1871611558
  NPD
• Straub Clinic & Hospital

  dba Hawaii Pacific Health Specialty Pharmacy

  • Community/Retail Pharmacy
  • Honolulu, HI
  • NPI 1295443216
  NPD
• Kapiolani Medical Center for Women & Children

  dba Kapiolani Medical Center Outpatient Pharmacy

  • Community/Retail Pharmacy
  • Honolulu, HI
  • NPI 1841263720
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Straub Clinic & Hospital

  dba Straub Benioff Medical Center

  • General Acute Care Hospital
  • Honolulu, HI
  • NPI 1720031701
  Care Compare affiliation
• Wilcox Memorial Hospital

  • Rural Acute Care Hospital
  • Lihue, HI
  • NPI 1225113442
  Care Compare affiliation

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

{
    "created_epoch": "1554336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1710449012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 JARRETT WHITE RD",
            "city": "TRIPLER ARMY MEDICAL CENTER",
            "state": "HI",
            "postal_code": "968595001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 JARRETT WHITE RD",
            "city": "TRIPLER ARMY MEDICAL CENTER",
            "state": "HI",
            "postal_code": "968595001",
            "telephone_number": "971-732-3174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACON",
        "first_name": "KOURT",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-04",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VA",
            "license": "0102206358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristy Arnold
• Olivia Arnold
• Lara Marie Au, PHARMD
• Jaime Avila, RD
• Kristin Baba
• Isabella Smolen Baeumler, DO
• Geraldine Baguio
• Obeth Bahena Gutierrez, MD
• Edward Hutchins Bailey, MD
• Emily Bailey, DVM

• Anesthesiology Physician in Tripler Army Medical Center, HI
• Providers in Tripler Army Medical Center, HI by specialty
• Anesthesiology Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2023; 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.

Verify at the official NPI Registry.