Individual provider Active NPI

Me Lavonne Fuimaono-Poe, APRN RX- NP C

  • Family Nurse Practitioner
  • Honolulu, HI
National Provider Identifier
1770750127
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN 1753 Issued in HI
Practice address
677 Ala Moana Blvd Ste 903
Honolulu, HI 96813-5416
Phone
(808) 308-0300
Fax
(833) 471-5801
NPI assigned
May 14, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN 1753 HI Primary

Addresses

Primary practice location

677 Ala Moana Blvd Ste 903
Honolulu, HI 96813-5416

Mailing address

1132 Bishop St Unit 1704
Honolulu, HI 96813-2893
Phone (808) 489-2925

Other practice location 1

1050 Queen St Ste 100
Honolulu, HI 96814-4130
Phone (808) 518-0299

Other identifiers 1

IdentifierTypeStateIssuer
539372-18MedicaidHI

Other names 1

  • Mrs. Mae Lavonne Fuimaono Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170310001862 HI Practitioner - Nurse Practitioner 6709160740 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN 1753HIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hoala I Ke Ola LLC CurrentSince Aug 24, 2024 Accepting new patients
Occmed Health and Wellness, LLC CurrentSince May 26, 2024 Accepting new patients

Locations

801 S Beretania St
Honolulu, HI 96813
Phone (808) 753-3935

677 Ala Moana Blvd
Ste 903
Honolulu, HI 96813
Phone (808) 308-0300

Interoperability endpoints

  • Direct secure messaging: me.fuimaono-poe.1@28590.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1210723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1770750127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1132 BISHOP ST UNIT 1704",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132893",
            "telephone_number": "808-489-2925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "677 ALA MOANA BLVD STE 903",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968135416",
            "telephone_number": "808-308-0300",
            "fax_number": "833-471-5801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1050 Queen St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968144130",
            "country_code": "US",
            "telephone_number": "808-518-0299",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FUIMAONO-POE",
        "first_name": "ME",
        "middle_name": "LAVONNE",
        "credential": "APRN RX- NP C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-14",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "APRN 1753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "539372-18",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAE",
            "last_name": "FUIMAONO",
            "middle_name": "LAVONNE",
            "prefix": "MRS.",
            "credential": "APRN-RX",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.