Individual provider Active NPI

Dianna L. Guenther, PA-C

  • Medical Physician Assistant
  • Hilo, HI
National Provider Identifier
1902081417
Registry record updated Jun 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
AMD-198 Issued in HI
Practice address
1292 Waianuenue Ave
Hilo, HI 96720-1228
Phone
(808) 934-4000
NPI assigned
Jan 2, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X AMD-198 HI Primary

Addresses

Primary practice location

1292 Waianuenue Ave
Hilo, HI 96720-1228

Mailing address

1292 Waianuenue Ave
Hilo, HI 96720-1228
Phone (808) 934-4000

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/interconnect-prodhim/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080207000224 HI Practitioner - Physician Assistant 1557444098 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hawaii Permanente Medical Group IncGroup PAC ID 7618880667, 705 clinicians

Practice addresses (Care Compare)

1292 Waianuenue Ave
Hilo, HI 96720-1228
Phone (808) 934-4000

3288 Moanalua Rd
Honolulu, HI 96819-1469
Phone (808) 432-0000

74 -517 Honokohau St
Kailua Kona, HI 96740-2715
Phone (808) 432-0000

80 Mahalani St
Wailuku, HI 96793-2531
Phone (808) 243-6000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
AMD-198HIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pukalani Family Practice, LLC PastSince Dec 27, 2020 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JCBAAA

Organizations & group practices 2

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": "1199232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1902081417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1292 WAIANUENUE AVE",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967201228",
            "telephone_number": "808-934-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1292 WAIANUENUE AVE",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967201228",
            "telephone_number": "808-934-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUENTHER",
        "first_name": "DIANNA",
        "middle_name": "L.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-02",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "HI",
            "license": "AMD-198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodhim/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1292 Waianuenue Ave",
            "city": "Hilo",
            "state": "HI",
            "country_code": "US",
            "postal_code": "967201228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hilo, HI

Sources for this page

Verify at the official NPI Registry.