Tracy Lynne Khan Fernando, MSN,APRN-RX,FNP-BC,A
Individual provider Active NPI Family Nurse Practitioner · Honolulu, HI
NPI 1770940892 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1770940892
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- APRN1979 (HI)
- Practice address
- 2239 N. School St.
Kokua Kalihi Valley
Honolulu, HI 96819 - Phone
- (808) 791-9410
- Fax
- (808) 847-6051
- NPI assigned
- Jan 20, 2016
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 11
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Queens University Medical Group
Kokua Kalihi Valley Comprehensive Family Services
Practice addresses (Care Compare)
1314 S King St
FL 2
Honolulu, HI 96814-1938
Phone (808) 691-6789
1380 Lusitana St
Honolulu, HI 96813-2448
2239 N School St
Honolulu, HI 96819-2539
Phone (808) 791-9400
Merit-based Incentive Payment System (MIPS)
- Final score
- 97.05 of 100
- Quality
- 89.81
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in HI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160425000368 | HI | Practitioner - Nurse Practitioner | 9931408036 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science - Nursing, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN1979 | HI | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Queen'S Medical Center | Current | Accepting new patients | |
| The Queen'S Medical Center | Current | Accepting new patients | |
| The Queens Medical Center | Current |
Accepting new patients | |
| Kokua Kalihi Valley Comprehensive Family Services | Current |
Accepting new patients | |
| Queens University Medical Group | Current |
Accepting new patients | |
| Kokua Kalihi Valley Comprehensive Family Services | Current |
Accepting new patients | |
| The Queens Medical Center | Current |
Accepting new patients | |
| Kokua Kalihi Valley Comprehensive Family Services | Past | Accepting new patients |
Locations
550 S Beretania St
Ste 404
Honolulu, HI 96813
Phone (808) 691-8897
1380 Lusitana St
Ste 913
Honolulu, HI 96813
Phone (808) 691-8521
2239 N School St
Honolulu, HI 96819
Phone (808) 791-9400
1301 Punchbowl St
Honolulu, HI 96813
Phone (808) 538-9011
Interoperability endpoints
- tracy.fernando@hawaiihie.medicity.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APRN1979 | HI | Yes |
Addresses
Primary practice location
2239 N. School St.
Kokua Kalihi Valley
Honolulu, HI 96819
Mailing address
2239 N. School St.
Kokua Kalihi Valley
Honolulu, HI 96819
Phone (808) 791-9410
Other names
- Tracy Lynne Fernando Atagi
Other providers in Honolulu, HI
- Mayumi Fernandez
- Mele Fernandez
- Melissa Ann Ugale Fernandez
- Trina Fernandez
- Christeen Fernando
- Jene Ferrante
- Andrea B Ferrebee
- Ariel Ferreira
- Jennifer Ferreira
- Nicholas Ferreira
All providers in Honolulu, HI · Family Nurse Practitioner in Hawaii
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.