Individual provider Active NPI

Brian Panganiban, PA-C

  • Physician Assistant
  • Honolulu, HI
National Provider Identifier
1790958734
Registry record updated Oct 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
AMD755 Issued in HI
Practice address
1301 Punchbowl St
Honolulu, HI 96813-2499
Phone
(808) 691-1000
NPI assigned
Apr 10, 2008
Last updated
Oct 12, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2738 TN
Physician Assistant 363A00000X AMD755 HI Primary

Addresses

Primary practice location

1301 Punchbowl St
Honolulu, HI 96813-2499

Mailing address

1301 Punchbowl St
Honolulu, HI 96813-2499
Phone (808) 691-1000

Other practice location 1

650 Joel Dr
Fort Campbell, KY 42223-5318
Phone (270) 798-8440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, HI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150804004408 TN Practitioner - Physician Assistant 8224342266
I20170626001532 HI Practitioner - Physician Assistant 8224342266 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Queens University Medical GroupGroup PAC ID 2466831557, 614 clinicians

Practice addresses (Care Compare)

1301 Punchbowl St
Honolulu, HI 96813-2499

1380 Lusitana St
Honolulu, HI 96813-2448

86-260 Farringtion Hwy
Waianae, HI 96792-3128
Phone (808) 697-3300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.05 of 100Reported as apm
Quality
89.81
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2738TNMDOptometrist
AMD755HIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Waianae District Comprehensive Health and Hospital Board, Incorporated CurrentSince May 3, 2020 Accepting new patients
The Queens Medical Center CurrentSince Jul 17, 2017 Accepting new patients
The Queens Medical Center CurrentSince Jul 17, 2017 Accepting new patients
Waianae District Comprehensive Health and Hospital Board, Incorporated CurrentSince May 3, 2020 Accepting new patients
Magpie Emergency Physicians PLLC Physician Assistant Past Accepting new patients
Sleep Center Hawaii LLC PastSince Feb 28, 2013 Accepting new patients
Waianae District Comprehensive Health and Hospital Board, Inc Past Accepting new patients

Locations

1301 Punchbowl St
Honolulu, HI 96813
Phone (808) 538-9011

550 S Beretania St
Ste 404
Honolulu, HI 96813
Phone (808) 691-8897

86-260 Farrington Hwy
Waianae, HI 96792
Phone (808) 696-7081

Interoperability endpoints

  • Direct secure messaging: brian.panganiban.p1@direct.wcchc.nextgenshare.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/JJCHAA

Organizations & group practices 9

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": "1207785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1790958734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 PUNCHBOWL ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132499",
            "telephone_number": "808-691-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 PUNCHBOWL ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132499",
            "telephone_number": "808-691-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "650 Joel Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Campbell",
            "state": "KY",
            "postal_code": "422235318",
            "country_code": "US",
            "telephone_number": "270-798-8440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANGANIBAN",
        "first_name": "BRIAN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-10",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "2738",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "HI",
            "license": "AMD755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.