Individual provider Active NPI

Ellen H Sofio, M.D.

  • Family Medicine Physician
  • Wahiawa, HI
National Provider Identifier
1770660565
Registry record updated Dec 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD5940 Issued in HI
Practice address
302 California Ave
Ste 210
Wahiawa, HI 96786-1841
Phone
(808) 291-4274
Fax
(808) 622-1808
NPI assigned
Nov 1, 2006
Last updated
Dec 2, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD5940 HI Primary

Addresses

Primary practice location

302 California Ave
Ste 210
Wahiawa, HI 96786-1841

Mailing address

302 California Ave
Ste 210
Wahiawa, HI 96786-1841
Phone (808) 291-4274

Other identifiers 1

IdentifierTypeStateIssuer
51863101MedicaidHI

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
I20130204000540 HI Practitioner - Family Practice 4981858644 Practice locations: Wahiawa, HI

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Hawaii John a. Burns School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

302 California Ave
Suite 210
Wahiawa, HI 96786-1841
Phone (808) 291-4274

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD5940HIMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: ellen.sofio@37210552664068.direct.elationemr.com

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480636800000",
    "number": "1770660565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 CALIFORNIA AVE",
            "address_2": "STE 210",
            "city": "WAHIAWA",
            "state": "HI",
            "postal_code": "967861841",
            "telephone_number": "808-291-4274",
            "fax_number": "808-622-1808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 CALIFORNIA AVE",
            "address_2": "STE 210",
            "city": "WAHIAWA",
            "state": "HI",
            "postal_code": "967861841",
            "telephone_number": "808-291-4274",
            "fax_number": "808-622-1808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOFIO",
        "first_name": "ELLEN",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2016-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "HI",
            "license": "MD5940",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "51863101",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wahiawa, HI

Sources for this page

Verify at the official NPI Registry.