Individual provider Active NPI

Peter RP Donnelly, MD

  • Family Medicine Physician
  • Mililani, HI
National Provider Identifier
1871573626
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD10133 Issued in HI
Practice address
95-390 Kuahelani Ave
Mililani, HI 96789
Phone
(808) 627-3200
Fax
(808) 623-7872
NPI assigned
Jan 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD10133 HI Primary

Addresses

Primary practice location

95-390 Kuahelani Ave
Mililani, HI 96789

Mailing address

128 Lehua St
Wahiawa, HI 96786
Phone (808) 621-8411

Other identifiers 2

IdentifierTypeStateIssuer
B215836MedicaidHI
25214102MedicaidHI

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
I20070807000157 HI Practitioner - Family Practice 4981795846 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD10133HIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health, LLC CurrentSince Sep 6, 2023 Accepting new patients
Randall H. Hirata M.D., Inc. CurrentSince Sep 3, 2022 Accepting new patients
Midpacific Hospitalists LLC Past Accepting new patients

Locations

82 Puuhonu Pl
Ste 209
Hilo, HI 96720
Phone (808) 796-3125

500 Ala Moana Blvd
Ste 7400
Honolulu, HI 96813
Phone (617) 823-6490

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

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": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1871573626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 LEHUA ST",
            "city": "WAHIAWA",
            "state": "HI",
            "postal_code": "96786",
            "telephone_number": "808-621-8411",
            "fax_number": "808-621-4117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95-390 KUAHELANI AVE",
            "city": "MILILANI",
            "state": "HI",
            "postal_code": "96789",
            "telephone_number": "808-627-3200",
            "fax_number": "808-623-7872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONNELLY",
        "first_name": "PETER",
        "middle_name": "RP",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "HI",
            "license": "MD10133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B215836",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "25214102",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mililani, HI

Sources for this page

Verify at the official NPI Registry.