Individual provider Active NPI

Maria Wilson, M.D.

  • Internal Medicine Physician
  • Kailua, HI
National Provider Identifier
1720344906
Registry record updated Jul 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD-12951 Issued in HI
Practice address
640 Ulukahiki St
Suite 103
Kailua, HI 96734-4454
Phone
(808) 263-5174
Fax
(808) 266-3614
NPI assigned
Apr 2, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD-12951 HI Primary

Addresses

Primary practice location

640 Ulukahiki St
Suite 103
Kailua, HI 96734-4454

Mailing address

640 Ulukahiki St
Suite 103
Kailua, HI 96734-4454
Phone (808) 263-5174

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
I20060314000647 HI Practitioner - Internal Medicine 6103833264 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
State University of Ny Upstate Medical University, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Castle Medical CenterGroup PAC ID 6608762778, 77 clinicians

Practice addresses (Care Compare)

30 Aulike St
Suite 300
Kailua, HI 96734-2751
Phone (808) 263-5015

Hospital & facility affiliations

  • Adventist Health Home Care Services Home health agency, Kaneohe, HI, CCN 127017
  • Adventist Health Castle Hospital, Kailua, HI, CCN 120006
  • Straub Clinic and Hospital Hospital, Honolulu, HI, CCN 120022

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-12951HIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Castle Medical Center Current Accepting new patients
Castle Physician Network CurrentSince Jul 18, 2016 Accepting new patients
Castle Medical Center Internal Medicine CurrentSince Jan 1, 2017 Accepting new patients
Castle Medical Center CurrentSince Jan 1, 2017 Accepting new patients
Castle Physician Network Internal Medicine CurrentSince Jul 18, 2016 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

321 N Kuakini St
Ste 201
Honolulu, HI 96817
Phone (808) 523-8611

30 Aulike St
Ste 501
Kailua, HI 96734
Phone (808) 263-5011

30 Aulike St
Ste 300
Kailua, HI 96734
Phone (808) 263-5015

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

660 Kailua Rd
Kailua, HI 96734
Phone (808) 263-2273

640 Ulukahiki St
Ste 103
Kailua, HI 96734
Phone (808) 263-5174

640 Ulukahiki St
#103
Kailua, HI 96734

30 Aulike St
Ste 303
Kailua, HI 96734
Phone (808) 261-1745

Organizations & group practices 6

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.

Hospital & facility affiliations 3

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": "1333324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404345600000",
    "number": "1720344906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 ULUKAHIKI ST",
            "address_2": "SUITE 103",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967344454",
            "telephone_number": "808-263-5174",
            "fax_number": "808-266-3614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 ULUKAHIKI ST",
            "address_2": "SUITE 103",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967344454",
            "telephone_number": "808-263-5174",
            "fax_number": "808-266-3614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MARIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-02",
        "last_updated": "2014-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "MD-12951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kailua, HI

Sources for this page

Verify at the official NPI Registry.