Kolinio Niumataiwalu, MBBS, DA
Individual provider Active NPI Anesthesiology Physician · Pago Pago, AS
NPI 1891925277 · NPPES record last updated Jan 21, 2025
Key facts
- NPI
- 1891925277
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anesthesiology Physician 207L00000X
- License
- 3064C (AS)
- Practice address
- PO Box LBJ
Pago Pago, AS 96799-0010 - Phone
- (684) 699-9681
- NPI assigned
- Jul 21, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240113000751 | AS | Practitioner - Anesthesiology | 9335032853 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3064C | AS | MD | Anesthesiology Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 3064C | AS | Yes |
Addresses
Primary practice location
PO Box LBJ
Pago Pago, AS 96799-0010
Mailing address
PO Box LBJ
Pago Pago, AS 96799-0010
Phone (684) 699-9681
Other providers in Pago Pago, AS
- Jasmine Julliam Muasau
- Rose Orisia Naesol
- Take Kolisi Naseri
- Joyce Niko
- Adi Kelera Q D Niumataiwalu
- Pacific Sleep Care
- Rosario Diokno Palo
- Alma Pati-Vaa
- Franklin A Payumo
- Susana Marieta Pene
All providers in Pago Pago, AS · Anesthesiology Physician in American Samoa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 21, 2025. 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.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.