Individual provider Active NPI

Kendra Kubo-Daronco, PA-C

  • Surgical Physician Assistant
  • Honolulu, HI
National Provider Identifier
1811632896
Registry record updated Sep 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
AMD-1120-0 Issued in HI
Practice address
1401 S Beretania St
Honolulu, HI 96814-1870
Phone
(808) 356-5699
NPI assigned
May 3, 2022
Last updated
Sep 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X AMD-1120-0 HI Primary

Addresses

Primary practice location

1401 S Beretania St
Honolulu, HI 96814-1870

Mailing address

1401 S Beretania St Ste 102
Honolulu, HI 96814-1871
Phone (808) 356-5699

Other identifiers 1

IdentifierTypeStateIssuer
AMD-1120-0OtherHIHAWAII MEDICAL BOARD- CERTIFIED PHYSICIAN ASSISTANT LICENSE

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
I20220802001865 HI Practitioner - Physician Assistant 5698157006 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AMD-1120-0HIMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Associates of Hawaii, LLP CurrentSince Jul 1, 2022 Accepting new patients

Locations

1401 S Beretania St
Ste 750
Honolulu, HI 96814
Phone (808) 521-8183

Organizations & group practices 3

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": "1651536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1811632896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 S BERETANIA ST STE 102",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968141871",
            "telephone_number": "808-356-5699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S BERETANIA ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968141870",
            "telephone_number": "808-356-5699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBO-DARONCO",
        "first_name": "KENDRA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-03",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "HI",
            "license": "AMD-1120-0",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAWAII MEDICAL BOARD- CERTIFIED PHYSICIAN ASSISTANT LICENSE",
            "identifier": "AMD-1120-0",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.