NPIMap

Organization Active NPI

Silversage Physician Services of Hawaii, Professional Corporation

  • Geriatric Medicine (Family Medicine) Physician
  • Kailua Kona, HI
National Provider Identifier
1902350846
Registry record updated Aug 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
Legal business name
SILVERSAGE PHYSICIAN SERVICES OF HAWAII, PROFESSIONAL CORPORATION
Practice address
78-6957 Kamehameha III Rd
Kailua Kona, HI 96740-2528
Phone
(808) 322-2528
NPI assigned
Aug 9, 2016
Last updated
Aug 31, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2016

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

Authorized official

Name
Kenneth L. Scott, D.O,NPI 1083699524
Title
President
Phone
(423) 815-1605

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QG0300X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0300X

Addresses

Primary practice location

78-6957 Kamehameha III Rd
Kailua Kona, HI 96740-2528

Mailing address

PO Box 22484
Chattanooga, TN 37422-2484
Phone (423) 815-1600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161025002830 HI Part B Supplier - Clinic/Group Practice 9032497094 Receives reassigned benefits from 12 practitioners
Practice locations: Hilo, HI; Waianae, HI; Wahiawa, HI; Makawao, HI; Lanai City, HI; Kaneohe, HI; Kailua Kona, HI; Honolulu, HI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1470700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472601600000",
    "number": "1902350846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22484",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374222484",
            "telephone_number": "423-815-1600",
            "fax_number": "423-763-1118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78-6957 KAMEHAMEHA III RD",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967402528",
            "telephone_number": "808-322-2528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SILVERSAGE PHYSICIAN SERVICES OF HAWAII, PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-09",
        "last_updated": "2016-08-31",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "423-815-1605",
        "authorized_official_credential": "D.O,"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kailua Kona, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.