Individual provider Active NPI

Katherine S. Heinzen Jim, M.D.

  • Emergency Medicine Physician
  • Kailua, HI
National Provider Identifier
1821032822
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD - 13731 Issued in HI
Practice address
407 Uluniu St
4TH Floor
Kailua, HI 96734-2519
Phone
(808) 261-3326
Fax
(808) 263-4604
NPI assigned
Jun 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD - 13731 HI Primary

Addresses

Primary practice location

407 Uluniu St
4TH Floor
Kailua, HI 96734-2519

Mailing address

PO Box 1266
Kailua, HI 96734-1266
Phone (808) 261-3326

Other identifiers 2

IdentifierTypeStateIssuer
0000259358OtherHIHMSA
579518MedicaidHI

Other names 1

  • Kate S. Heinzen Former name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060809000069 HI Practitioner - Emergency Medicine 2567465701 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD - 13731HIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Clinical Education & Research Associates CurrentSince Feb 15, 2018 Accepting new patients
University Clinical Education & Research Associates CurrentSince Feb 15, 2018 Accepting new patients
Hawaii Emergency Physicians Associated Inc Emergency Medicine CurrentSince Jul 1, 2006 Accepting new patients
Midpacific Hospitalists LLC Past Accepting new patients

Locations

98-1079 Moanalua Rd
Aiea, HI 96701
Phone (808) 485-4301

45-547 Plumeria St
Honokaa, HI 96727
Phone (808) 775-7211

640 Ulukahiki St
Kailua, HI 96734
Phone (808) 261-3326

407 Uluniu St
Fl 4
Kailua, HI 96734
Phone (808) 261-3326

79-1019 Haukapila St
Kealakekua, HI 96750
Phone (808) 322-4413

128 Lehua St
Wahiawa, HI 96786
Phone (808) 621-4330

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821032822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1266",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967341266",
            "telephone_number": "808-261-3326",
            "fax_number": "808-263-4604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 ULUNIU ST",
            "address_2": "4TH FLOOR",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967342519",
            "telephone_number": "808-261-3326",
            "fax_number": "808-263-4604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEINZEN JIM",
        "first_name": "KATHERINE",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "HI",
            "license": "MD - 13731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "0000259358",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "579518",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATE",
            "last_name": "HEINZEN",
            "middle_name": "S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kailua, HI

Sources for this page

Verify at the official NPI Registry.