Ibid M Nicolaisen, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN-2139 Issued in HI

Practice address

81-980 Halekii St Ste 107
Kealakekua, HI 96750-8177

Phone

(808) 324-0703

NPI assigned

Jul 5, 2016

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

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

Creighton University School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

West Hawaii Community Health Center IncGroup PAC ID 1557389400, 63 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kona Community Hospital Hospital, Kealakekua, HI, CCN 120019

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 and National Provider Directory roles.

• West Hawaii Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Kailua Kona, HI
  • NPI 1952335630
  Medicare reassignment Care Compare group NPD
• West Hawaii Community Health Center, Inc.

  dba Hawaii Island Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Pahoa, HI
  • NPI 1861376907
  NPD

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

• Kona Hospital

  dba Kona Community Hospital

  • General Acute Care Hospital
  • Kealakekua, HI
  • NPI 1952332991
  Care Compare affiliation

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

{
    "created_epoch": "1467676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614211200000",
    "number": "1780036517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75-5751 KUAKINI HWY STE 203",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967401753",
            "telephone_number": "808-326-5629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81-980 HALEKII ST STE 107",
            "city": "KEALAKEKUA",
            "state": "HI",
            "postal_code": "967508177",
            "telephone_number": "808-324-0703"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75-5751 Kuakini Hwy",
            "address_2": "Ste 203",
            "address_purpose": "LOCATION",
            "city": "Kailua Kona",
            "state": "HI",
            "postal_code": "967401752",
            "country_code": "US",
            "telephone_number": "808-326-5629",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICOLAISEN",
        "first_name": "IBID",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-05",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A117690",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "APRN-2139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James M Nagao
• Sangeetha Nair, LMFT
• Kent Haruo Nakamaru, DDS
• Nicole Lee Nazemi, DO
• Michael C. Nichols, M.D.
• Kelsi Nishina, MS, RDN, LDN
• Patrick K. Okamura, M.D.
• Krista Olson, IBCLC
• Swami Malama Om
• Oshima Bros., Inc. (Oshima Drug)

• Family Nurse Practitioner in Kealakekua, HI
• Providers in Kealakekua, HI by specialty
• Family Nurse Practitioner in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2021; 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.