Individual provider Active NPI

Brettany-Anne Clemens

  • Family Nurse Practitioner
  • Honolulu, HI
National Provider Identifier
1780464925
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN-4268 Issued in HI
Practice address
277 Ohua Ave
Honolulu, HI 96815-6612
Phone
(808) 922-4787
NPI assigned
Oct 4, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

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-4268 HI Primary

Addresses

Primary practice location

277 Ohua Ave
Honolulu, HI 96815-6612

Mailing address

277 Ohua Ave
Honolulu, HI 96815-6612

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
I20240822001077 HI Practitioner - Nurse Practitioner 3072052000 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Waikiki HealthGroup PAC ID 9335058536, 27 clinicians

Practice addresses (Care Compare)

277 Ohua Ave
Honolulu, HI 96815-3643

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN-4268HIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Waikiki Health CurrentSince Jun 16, 2024 Accepting new patients
Waikiki Health Current Accepting new patients

Locations

277 Ohua Ave
Honolulu, HI 96815
Phone (808) 791-9355

1903 Palolo Ave
Honolulu, HI 96816
Phone (808) 922-4787

845 22nd Ave
#5
Honolulu, HI 96816
Phone (808) 734-2034

845 22nd Ave
Honolulu, HI 96816
Phone (808) 732-2802

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1696377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1780464925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "277 OHUA AVE",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968156612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "277 OHUA AVE",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968156612",
            "telephone_number": "808-922-4787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMENS",
        "first_name": "BRETTANY-ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-04",
        "last_updated": "2023-10-04",
        "certification_date": "2023-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "APRN-4268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.