Individual provider Active NPI

Marko Vasic, MD

  • Internal Medicine Physician
  • Wahiawa, HI
National Provider Identifier
1720431695
Registry record updated Oct 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD-21994 Issued in HI
Practice address
302 California Ave Ste 106
Wahiawa, HI 96786-1841
Phone
(808) 622-1618
NPI assigned
Jul 15, 2016
Last updated
Oct 18, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2021

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-21994 HI Primary

Addresses

Primary practice location

302 California Ave Ste 106
Wahiawa, HI 96786-1841

Mailing address

302 California Ave Ste 106
Wahiawa, HI 96786-1841

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
I20210827000600 HI Practitioner - Internal Medicine 4486059540 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Wahiawa Center for Community HealthGroup PAC ID 6608154182, 16 clinicians

Practice addresses (Care Compare)

130 California Ave
Suite 106
Wahiawa, HI 96786-1554
Phone (808) 622-1618

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Wahiawa Center for Community Health CurrentSince Sep 10, 2021 Accepting new patients

Locations

130 California Ave
Ste 106
Wahiawa, HI 96786
Phone (808) 622-1618

302 California Ave
Ste 106
Wahiawa, HI 96786
Phone (808) 622-1618

Interoperability endpoints

  • Direct secure messaging: marko.vasic.1@15549.direct.athenahealth.com

Organizations & group practices 1

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.

Hospital & facility affiliations 2

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": "1468540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634515200000",
    "number": "1720431695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 CALIFORNIA AVE STE 106",
            "city": "WAHIAWA",
            "state": "HI",
            "postal_code": "967861841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 CALIFORNIA AVE STE 106",
            "city": "WAHIAWA",
            "state": "HI",
            "postal_code": "967861841",
            "telephone_number": "808-622-1618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASIC",
        "first_name": "MARKO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-15",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "MD-21994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wahiawa, HI

Sources for this page

Verify at the official NPI Registry.