Agnela Teresa Isaias, MD

Key facts

NPI

1790772572

Entity type

Individual (NPI type 1)

Primary specialty

Pediatrics Physician 208000000X

License

MD-23703 (HI)

Practice address

99-128 Aiea Heights Dr Ste 211
Aiea, HI 96701-3972

Phone

(808) 488-8441

NPI assigned

Oct 5, 2005

Sex

Female

Sole proprietor

No

Organizations & group practices 8

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.

• Centro de Salud de la Comunidad de San Ysidro, Inc. Federally Qualified Health Center (FQHC) · San Diego, CA · NPI 1124782685
  Medicare reassignment NPD CA
• Community Health Centers of the Central Coast Inc Federally Qualified Health Center (FQHC) · Oceano, CA · NPI 1336166248
  Medicare reassignment NPD CA
• Agnela Isaias LLC Pediatrics Physician · Aiea, HI · NPI 1730944083
  NPD Authorized official PEDIATRICS
• Centro de Salud de la Comunidad de San Ysidro Inc Federally Qualified Health Center (FQHC) · San Diego, CA · NPI 1457033813
  NPD
• Centro de Salud de la Comunidad de San Ysidro, Inc. Federally Qualified Health Center (FQHC) · San Diego, CA · NPI 1538262092
  NPD
• Community Health Centers of the Central Coast Inc Federally Qualified Health Center (FQHC) · San Luis Obispo, CA · NPI 1275553257
  NPD
• Community Health Centers of the Central Coast Inc Federally Qualified Health Center (FQHC) · Santa Maria, CA · NPI 1447277355
  NPD
• Community Health Centers of the Central Coast Inc Federally Qualified Health Center (FQHC) · Cambria, CA · NPI 1881611705
  NPD

Medicare participation

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 13, 2024.

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1790772572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3779 KUMULANI PL",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968221113",
            "telephone_number": "858-472-9950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99-128 AIEA HEIGHTS DR STE 211",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967013972",
            "telephone_number": "808-488-8441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISAIAS",
        "first_name": "AGNELA",
        "middle_name": "TERESA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-05",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "HI",
            "license": "MD-23703",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "82912",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "051524720",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009971875",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in Aiea, HI · Pediatrics Physician in Hawaii