Individual provider Active NPI

Amy Wry Jenkins, MD

  • Pediatrics Physician
  • Wahiawa, HI
National Provider Identifier
1851883250
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD-22009-0 Issued in HI
Practice address
302 California Ave
Wahiawa, HI 96786-1841
Phone
(808) 651-1741
NPI assigned
May 31, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD-22009-0 HI Primary

Addresses

Primary practice location

302 California Ave
Wahiawa, HI 96786-1841

Mailing address

1356 Lusitana St Ste 510
Honolulu, HI 96813-2409
Phone (808) 651-1741

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
I20210909003191 HI Practitioner - Pediatric Medicine 6901202373 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-22009-0HIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Wahiawa Center for Community Health CurrentSince Jul 14, 2021 Accepting new patients
Straub Clinic & Hospital Past Accepting new patients

Locations

130 California Ave
Ste 106
Wahiawa, HI 96786
Phone (808) 622-1618

302 California Ave
Ste 106
Wahiawa, HI 96786
Phone (808) 622-1618

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1527724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1851883250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1356 LUSITANA ST STE 510",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132409",
            "telephone_number": "808-651-1741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 CALIFORNIA AVE",
            "city": "WAHIAWA",
            "state": "HI",
            "postal_code": "967861841",
            "telephone_number": "808-651-1741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "AMY",
        "middle_name": "WRY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-31",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "HI",
            "license": "MD-22009-0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wahiawa, HI

Sources for this page

Verify at the official NPI Registry.