Individual provider Active NPI

Ronnie Trevor Otieno, DO

  • Family Medicine Physician
  • Honolulu, HI
National Provider Identifier
1760063739
Registry record updated Aug 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DOS-2674-0 Issued in HI
Practice address
1441 Kapiolani Blvd Ste 2020
Honolulu, HI 96814-4408
Phone
(808) 439-6201
NPI assigned
Apr 20, 2021
Last updated
Aug 13, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2024-01933 NC
Family Medicine Physician 207Q00000X DOS-2674-0 HI Primary

Addresses

Primary practice location

1441 Kapiolani Blvd Ste 2020
Honolulu, HI 96814-4408

Mailing address

1441 Kapiolani Blvd Ste 2020
Honolulu, HI 96814-4408
Phone (808) 439-6201

Other practice location 1

94-673 Kupuohi St
Waipahu, HI 96797-5367
Phone (808) 439-6201

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, HI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240906002259 NC Practitioner - Family Practice 9931649894 Reassigns benefits to 1 organization
I20250716001682 HI Practitioner - Family Practice 9931649894 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paul N Morton LLCGroup PAC ID 4385055623, 4 clinicians

Practice addresses (Care Compare)

1380 Lusitana St
Suite 808
Honolulu, HI 96813-2444
Phone (808) 439-6201

75 Puuhonu PL
Suite 204
Hilo, HI 96720-2000
Phone (808) 439-6201

94 -673 Kupuohi St
Suite C205
Waipahu, HI 96797-5373
Phone (808) 439-6201

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DOS-2674-0HIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Paul N Morton LLC CurrentSince Apr 11, 2025 Accepting new patients
Henderson County Urgent Care Center Inc CurrentSince May 1, 2025 Accepting new patients
Paul N Morton LLC CurrentSince Apr 11, 2025 Accepting new patients
Henderson County Hospital Corporation Family Medicine PastSince May 1, 2025 Accepting new patients

Locations

1380 Lusitana St
Ste 808
Honolulu, HI 96813
Phone (808) 439-6201

1441 Kapiolani Blvd
Ste 2020
Honolulu, HI 96814
Phone (808) 439-6201

212 Thompson St
Ste A
Hendersonvlle, NC 28792
Phone (828) 697-3232

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1618876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1760063739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 KAPIOLANI BLVD STE 2020",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968144408",
            "telephone_number": "808-439-6201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 KAPIOLANI BLVD STE 2020",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968144408",
            "telephone_number": "808-439-6201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "94-673 Kupuohi St",
            "address_purpose": "LOCATION",
            "city": "Waipahu",
            "state": "HI",
            "postal_code": "967975367",
            "country_code": "US",
            "telephone_number": "808-439-6201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OTIENO",
        "first_name": "RONNIE",
        "middle_name": "TREVOR",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-20",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2024-01933",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "HI",
            "license": "DOS-2674-0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.