NPIMap

Individual provider Active NPI

Candice Tiffany Myhre, MD

  • Emergency Medicine Physician
  • Marina del Rey, CA
National Provider Identifier
1871543710
Registry record updated May 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A789420 Issued in CA
Practice address
4650 Lincoln Blvd
Daniel Freeman Marina Hospital Ed
Marina del Rey, CA 90292
Phone
(310) 822-6005
NPI assigned
May 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2008

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 A789420 CA Primary

Addresses

Primary practice location

4650 Lincoln Blvd
Daniel Freeman Marina Hospital Ed
Marina del Rey, CA 90292

Mailing address

201 44TH Street
Manhattan Beach, CA 90266
Phone (310) 944-2623

Other identifiers 2

IdentifierTypeStateIssuer
00A789420OtherBLUE SHIELD
00A789420MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150331000319 HI Practitioner - Emergency Medicine 2769454123 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Southern California Keck School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hawaii Emergency Physicians Associated IncGroup PAC ID 2860390283, 119 clinicians

Practice addresses (Care Compare)

79 -1019 Haukapila St
Kealakekua, HI 96750-7920
Phone (808) 322-9311

Hospital & facility affiliations

  • Wilcox Memorial Hospital Hospital, Lihue, HI, CCN 120014
  • Kona Community Hospital Hospital, Kealakekua, HI, CCN 120019

Merit-based Incentive Payment System (MIPS)

Final score
88.39 of 100Reported as group
Quality
79.9
Promoting interoperability
99
Improvement activities
40
Cost
82.23

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A789420CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kauai Medical Clinic CurrentSince Mar 10, 2020 Accepting new patients
Kauai Medical Clinic CurrentSince Mar 10, 2020 Accepting new patients
Providence Facey Medical Foundation PastSince Jan 20, 2017 Accepting new patients
Memorial Emergency Physicians Medical Group, Inc Past Accepting new patients
Phalarope Inpatient Services, a Medical Corporation Past Accepting new patients
Beach Cities Urgent Care Center Emergency Medicine Past Accepting new patients
California Em-I Medical Services, a Medical Corporation Emergency Medicine Past Accepting new patients
Beach Cities Emergency Medical Group Inc Emergency Medicine Past Accepting new patients
Midpacific Hospitalists LLC Past Accepting new patients

Locations

3-3420 Kuhio Hwy
Ste B
Lihue, HI 96766
Phone (808) 245-1500

Organizations & group practices 10

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.

Hospital & facility affiliations 2

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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211328000000",
    "number": "1871543710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 44TH STREET",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "90266",
            "telephone_number": "310-944-2623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 LINCOLN BLVD",
            "address_2": "DANIEL FREEMAN MARINA HOSPITAL ED",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "90292",
            "telephone_number": "310-822-6005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYHRE",
        "first_name": "CANDICE",
        "middle_name": "TIFFANY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-11",
        "last_updated": "2008-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A789420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00A789420",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A789420",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marina del Rey, CA

Sources for this page

Verify at the official NPI Registry.