Individual provider Active NPI

Keely Hiraoka, PA-C

  • Physician Assistant
  • Kealakekua, HI
National Provider Identifier
1811663354
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
81-6627 Mamalahoa Hwy Ste B3
Kealakekua, HI 96750-8180
Phone
(808) 324-0703
NPI assigned
Aug 16, 2021
Last updated
Feb 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

81-6627 Mamalahoa Hwy Ste B3
Kealakekua, HI 96750-8180

Mailing address

75-5751 Kuakini Hwy Ste 203
Kailua Kona, HI 96740-1753
Phone (808) 326-5629

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
I20240505000040 HI Practitioner - Physician Assistant 2860832029 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

68 -1845 Waikoloa Rd
Suite 207
Waikoloa, HI 96738-5581
Phone (808) 769-5160

75-5751 Kuakini Hwy
Suite 101a
Kailua Kona, HI 96740-1705
Phone (808) 326-5629

75-5751 Kuakini Hwy
Suite 203
Kailua Kona, HI 96740

75-5751 Kuakini Hwy 203
Kailua Kona, HI 96740-1752

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
West Hawaii Community Health Center, Inc. CurrentSince Apr 29, 2024 Accepting new patients
West Hawaii Community Health Center, Inc. CurrentSince Apr 29, 2024 Accepting new patients

Locations

75-5751 Kuakini Hwy
Ste 101A
Kailua Kona, HI 96740

75-5751 Kuakini Hwy
Ste 203
Kailua Kona, HI 96740
Phone (808) 326-3878

81-6627 Mamalahoa Hwy
Ste B3
Kealakekua, HI 96750
Phone (808) 323-8005

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, 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": "1629072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1811663354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75-5751 KUAKINI HWY STE 203",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967401753",
            "telephone_number": "808-326-5629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81-6627 MAMALAHOA HWY STE B3",
            "city": "KEALAKEKUA",
            "state": "HI",
            "postal_code": "967508180",
            "telephone_number": "808-324-0703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIRAOKA",
        "first_name": "KEELY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-16",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kealakekua, HI

Sources for this page

Verify at the official NPI Registry.