Individual provider Active NPI

Agnela Teresa Isaias, MD

  • Pediatrics Physician
  • Aiea, HI
National Provider Identifier
1790772572
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD-23703 Issued in HI
Practice address
99-128 Aiea Heights Dr Ste 211
Aiea, HI 96701-3972
Phone
(808) 488-8441
NPI assigned
Oct 5, 2005
Last updated
Feb 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD-23703 HI Primary
Pediatrics Physician 208000000X 82912 CA

Addresses

Primary practice location

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

Mailing address

3779 Kumulani PL
Honolulu, HI 96822-1113
Phone (858) 472-9950

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130718000158 CA Practitioner - Pediatric Medicine 4789640186 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
82912CAMDPharmacist
MD-23703HIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centro de Salud de la Comunidad de San Ysidro, Inc. Current Accepting new patients
Community Health Centers of the Central Coast Inc Current Accepting new patients
Community Health Centers of the Central Coast Inc Current Accepting new patients
Community Health Centers of the Central Coast Inc Current Accepting new patients
Centro de Salud de la Comunidad de San Ysidro Inc CurrentSince Jul 9, 2018 Accepting new patients
Centro de Salud de la Comunidad de San Ysidro, Inc. CurrentSince Jul 9, 2018 Accepting new patients
Agnela Isaias LLC Pediatrics CurrentSince Feb 18, 2024 Accepting new patients
Community Health Centers of the Central Coast Inc CurrentSince May 26, 2013 Accepting new patients

Locations

1637 Third Ave
Ste B
Chula Vista, CA 91911
Phone (619) 425-1780

280 E St
Chula Vista, CA 91910
Phone (619) 425-3951

1136 D Ave
National City, CA 91950
Phone (619) 336-2300

150 Tejas Pl
Nipomo, CA 93444
Phone (805) 929-3254

1601 Precision Park Ln
San Ysidro, CA 92173
Phone (619) 205-4585

2050 S Blosser Rd
Santa Maria, CA 93458
Phone (805) 361-8014

2801 Santa Maria Way
Santa Maria, CA 93455
Phone (805) 934-5400

99-128 Aiea Heights Dr
Ste 211
Aiea, HI 96701
Phone (808) 488-8441

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "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": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiea, HI

Sources for this page

Verify at the official NPI Registry.