Pono Podiatry, LLC
Organization Active NPI Foot Surgery Podiatrist · Lahaina, HI
NPI 1891208930 · NPPES record last updated Jun 25, 2021
Key facts
- NPI
- 1891208930
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Foot Surgery Podiatrist 213ES0131X
- License
- PO-202 (HI)
- Legal business name
- PONO PODIATRY, LLC
- Practice address
- 40 Kupuohi St Ste 204
Lahaina, HI 96761-2714 - Phone
- (808) 727-2117
- Fax
- (808) 793-2238
- NPI assigned
- Nov 12, 2017
- Organization subpart
- No
Authorized official
- Name
- Dr. David Wing Lee, DPM
- Title
- Owner
- Phone
- (808) 727-2117
Practitioners 1
-
David Wing Lee, DPM
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in HI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180228001478 | HI | Part B Supplier - Clinic/Group Practice | 8628336237 |
Receives reassigned benefits from 1 practitioner Practice locations: Lahaina, HI |
National Provider Directory
Locations
40 Kupuohi St
Ste 204
Lahaina, HI 96761
Phone (808) 727-2117
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot Surgery Podiatrist |
213ES0131X | PO-202 | HI | Yes |
Addresses
Primary practice location
40 Kupuohi St Ste 204
Lahaina, HI 96761-2714
Mailing address
40 Kupuohi St Ste 204
Lahaina, HI 96761-2714
Phone (808) 727-2117
Other providers in Lahaina, HI
- Haylee Sarae Patch
- Tita Lynette Perez
- Connie Marie Perkins
- Shantelle Lea Pierce
- Lithe Pokipala-Waiohu
- Michelle Pontell
- Positive Pathways LLC
- Ernesto J Prado
- Vanessa Rene Probert
- Barry Probst
All providers in Lahaina, HI · Foot Surgery Podiatrist in Hawaii
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 25, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.