NPIMap

Organization Active NPI

Minuteclinic Diagnostic of Hawaii, L.L.C.

  • Family Nurse Practitioner
  • Kaneohe, HI
National Provider Identifier
1720329923
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
MINUTECLINIC DIAGNOSTIC OF HAWAII, L.L.C.
Practice address
45-480 Kaneohe Bay Dr
Kaneohe, HI 96744
Phone
(866) 389-2727
NPI assigned
Mar 13, 2013
Last updated
Jun 24, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
MINUTECLINIC DIAGNOSTIC OF HAWAII, L.L.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

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

Authorized official

Name
Deborah Pincince
Title
Administrator
Phone
(401) 770-3813

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NU Primary
Professional Counselor 101YP2500X NU
Clinical Social Worker 1041C0700X NU
Marriage & Family Therapist 106H00000X NU

Addresses

Primary practice location

45-480 Kaneohe Bay Dr
Kaneohe, HI 96744

Mailing address

1 CVS Dr
MC 2295
Woonsocket, RI 02895-6146
Phone (401) 770-3813

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131115001210 HI Part B Supplier - Clinic/Group Practice 6507092863 Receives reassigned benefits from 64 practitioners
Practice locations: Aiea, HI; Honolulu, HI; Kaneohe, HI; Kapolei, HI; Wahiawa, HI

National Provider Directory

National Provider Directory
Tax ID family
Minuteclinic Diagnostic of Hawaii LLC3 organizations share this tax ID, including this one
Part of
Minuteclinic Diagnostic of Hawaii LLC

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

2155 Kalakaua Ave
Honolulu, HI 96815
Phone (808) 342-6305

4211 Waialae Ave
Honolulu, HI 96816
Phone (808) 732-0782

925 California Ave
Wahiawa, HI 96786
Phone (808) 621-7772

Practitioners & affiliated clinicians

Practitioners 66

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 66

NPI Registry JSON

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

{
    "created_epoch": "1363132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719187200000",
    "number": "1720329923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CVS DR",
            "address_2": "MC 2295",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028956146",
            "telephone_number": "401-770-3813",
            "fax_number": "770-216-3549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45-480 KANEOHE BAY DR",
            "city": "KANEOHE",
            "state": "HI",
            "postal_code": "96744",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINUTECLINIC DIAGNOSTIC OF HAWAII, L.L.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MINUTECLINIC DIAGNOSTIC OF HAWAII, L.L.C.",
        "enumeration_date": "2013-03-13",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A",
        "authorized_official_last_name": "PINCINCE",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "401-770-3813"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kaneohe, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.