Beverly Lauron Gaboya Inocencio, ACNP-BC, CCRN, CEN

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

1601 Issued in HI

Practice address

1301 Punchbowl St
Emergency Department
Honolulu, HI 96813-2402

Phone

(808) 551-6782

NPI assigned

Nov 5, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Pali Momi Medical CenterGroup PAC ID 6406746916, 90 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Pali Momi Medical Center Hospital, Aiea, HI, CCN 120026

Merit-based Incentive Payment System (MIPS)

Final score

83.35 of 100Reported as group

Quality

67.49

Promoting interoperability

100

Improvement activities

40

Cost

77

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Pali Momi Medical Center

  • Multi-Specialty Clinic/Center
  • Aiea, HI
  • NPI 1275588329
  Medicare reassignment Care Compare group NPD
• The Emergency Group, Inc.

  • Emergency Medicine Physician
  • Honolulu, HI
  • NPI 1013943414
  Medicare reassignment NPD
• Pali Momi Medical Center

  dba Pali Momi Medical Center Outpatient Pharmacy

  • Community/Retail Pharmacy
  • Aiea, HI
  • NPI 1851364731
  NPD

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

• Pali Momi Medical Center

  • General Acute Care Hospital
  • Aiea, HI
  • NPI 1013961408
  Care Compare affiliation

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

{
    "created_epoch": "1352073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448841600000",
    "number": "1750635371",
    "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": "808-551-6782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 PUNCHBOWL ST",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132402",
            "telephone_number": "808-551-6782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INOCENCIO",
        "first_name": "BEVERLY",
        "middle_name": "LAURON GABOYA",
        "name_prefix": "Dr.",
        "credential": "ACNP-BC, CCRN, CEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-05",
        "last_updated": "2015-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "HI",
            "license": "1601",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "639381",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAWAII APRN-RX LICENSE",
            "identifier": "1601",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Injury Care Clinic Inc
• Mykayla Jean Innerst, BEHAVIOR TECHNICIAN
• Innervate LLC
• Innova Recovery, PLLC (Innova Recovery Center)
• Takuro Ino
• Tracie M Inouchi, O.D.
• Greg Inoue, RPH
• Hideru Inoue, CRNA
• Kourtney K. Inoue, RD
• Shane Inoue, M.D.

• Acute Care Nurse Practitioner in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Acute Care Nurse Practitioner in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2015; 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.