Individual provider Active NPI

Kitty Victoria, MD

  • Medical Oncology Physician
  • Kealakekua, HI
National Provider Identifier
1871917633
Registry record updated Aug 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
20971 Issued in HI
Practice address
79-1019 Haukapila St
Kealakekua, HI 96750-7920
Phone
(347) 571-7576
NPI assigned
Feb 13, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X MTL-2024-010 GU
Hematology & Oncology Physician 207RH0003X M-2444 GU
Medical Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RX0202X 20971 HI Primary

Addresses

Primary practice location

79-1019 Haukapila St
Kealakekua, HI 96750-7920

Mailing address

79-1019 Haukapila St
Kealakekua, HI 96750-7920
Phone (808) 322-6910

Other practice location 1

506 6th St
Brooklyn, NY 11215-3609
Phone (862) 253-3447

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GU
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
I20240530004285 GU Practitioner - Hematology/Oncology 1052682069 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

133 Route 3
Dededo, GU 96929-6911
Phone (671) 645-5500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.22 of 100Reported as group
Quality
78.84
Improvement activities
40
Cost
61.61

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20971HIMDMedical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Guam Healthcare Development Incorporated Multi-Specialty CurrentSince Apr 15, 2024 Accepting new patients

Locations

133 Route 3
Dededo, GU 96929
Phone (671) 645-5500

Organizations & group practices 1

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 1

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": "1392249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1871917633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79-1019 HAUKAPILA ST",
            "city": "KEALAKEKUA",
            "state": "HI",
            "postal_code": "967507920",
            "telephone_number": "808-322-6910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79-1019 HAUKAPILA ST",
            "city": "KEALAKEKUA",
            "state": "HI",
            "postal_code": "967507920",
            "telephone_number": "347-571-7576"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "506 6th St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112153609",
            "country_code": "US",
            "telephone_number": "862-253-3447",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VICTORIA",
        "first_name": "KITTY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-13",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "GU",
            "license": "MTL-2024-010",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "GU",
            "license": "M-2444",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "HI",
            "license": "20971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kealakekua, HI

Sources for this page

Verify at the official NPI Registry.