Individual provider Active NPI

Carmelli Agdeppa

  • Family Nurse Practitioner
  • Honolulu, HI
National Provider Identifier
1780576124
Registry record updated Jul 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4977 Issued in HI
Practice address
820 Mililani St Ste 400
Honolulu, HI 96813-2934
Phone
(808) 550-2552
NPI assigned
Jul 18, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2025

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 4977 HI Primary

Addresses

Primary practice location

820 Mililani St Ste 400
Honolulu, HI 96813-2934

Mailing address

820 Mililani St Ste 400
Honolulu, HI 96813-2934
Phone (808) 550-2552

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
I20251030001113 HI Practitioner - Nurse Practitioner 2961991997 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Islands Hospice, Inc.Group PAC ID 1254494172, 2 clinicians

Practice addresses (Care Compare)

Honolulu, HI 96813
Phone (808) 550-2552

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4977HIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Islands Hospice, Inc. CurrentSince Aug 11, 2025 Accepting new patients
Milestones CurrentSince Jul 22, 2025 Accepting new patients

Locations

12680 High Bluff Dr
Ste 150
San Diego, CA 92130

820 Mililani St
Ste 400
Honolulu, HI 96813
Phone (808) 550-2552

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17047/brand/1/csg/1/fhir/r4

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1752796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752796800000",
    "number": "1780576124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 MILILANI ST STE 400",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132934",
            "telephone_number": "808-550-2552",
            "fax_number": "808-550-2552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 MILILANI ST STE 400",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132934",
            "telephone_number": "808-550-2552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGDEPPA",
        "first_name": "CARMELLI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-18",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "4977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.