Individual provider Active NPI

Olivia Agtarap Pascual, FNP-BC

  • Family Nurse Practitioner
  • Lanai City, HI
National Provider Identifier
1841058401
Registry record updated Mar 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN-4493 Issued in HI
Practice address
333 Sixth Street
Lanai City, HI 96763
Phone
(808) 565-6919
Fax
(808) 565-9111
NPI assigned
Mar 8, 2024
Last updated
Mar 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN-4493 HI Primary

Addresses

Primary practice location

333 Sixth Street
Lanai City, HI 96763

Mailing address

PO Box 630142
Lanai City, HI 96763-0142
Phone (808) 565-6919

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
I20240410003678 HI Practitioner - Nurse Practitioner 4587002431 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Southern California Keck School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lanai Community Health CenterGroup PAC ID 5395828925, 7 clinicians

Practice addresses (Care Compare)

333 6TH St
Lanai City, HI 96763-8035
Phone (808) 565-6919

478 Lauhala Place
Lanai City, HI 96763-0142

PO Box
Suite 630142
Lanai City, HI 96763

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN-4493HIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lanai Community Health Center CurrentSince Mar 12, 2024 Accepting new patients
Lanai Community Health Center CurrentSince Mar 5, 2024 Accepting new patients
West Hawaii Community Health Center, Inc. Past Accepting new patients

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": "1709856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709856000000",
    "number": "1841058401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 630142",
            "city": "LANAI CITY",
            "state": "HI",
            "postal_code": "967630142",
            "telephone_number": "808-565-6919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 SIXTH STREET",
            "city": "LANAI CITY",
            "state": "HI",
            "postal_code": "96763",
            "telephone_number": "808-565-6919",
            "fax_number": "808-565-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASCUAL",
        "first_name": "OLIVIA",
        "middle_name": "AGTARAP",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-08",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "APRN-4493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lanai City, HI

Sources for this page

Verify at the official NPI Registry.