Ian Keaupuni Awai, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA61491021 Issued in WA

Practice address

15214 Canyon Rd E Ste 120
Puyallup, WA 98375-7457

Phone

(253) 539-6078

Fax

(253) 539-6045

NPI assigned

Mar 3, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in HI, WA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ian.awai@24530103894020.direct.elationemr.com

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.

• Franciscan Medical Group

  • Orthopaedic Surgery Physician
  • Silverdale, WA
  • NPI 1093165334
  Medicare reassignment
• Western Washington Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Parkland, WA
  • NPI 1801352505
  Medicare reassignment
• Medical Clinic, Inc.

  • Multi-Specialty Clinic/Center
  • Kailua, HI
  • NPI 1144234402
  Medicare reassignment
• Queens University Medical Group

  • Multi-Specialty Clinic/Center
  • Honolulu, HI
  • NPI 1891441382
  Medicare reassignment
• Franciscan Medical Group

  • Internal Medicine Physician
  • Bremerton, WA
  • NPI 1154564649
  NPD
• Franciscan Medical Group

  • Family Medicine Physician
  • Tacoma, WA
  • NPI 1366539421
  NPD
• Franciscan Medical Group

  • Family Medicine Physician
  • Gig Harbor, WA
  • NPI 1386602555

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1614729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1902491707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15214 CANYON RD E STE 120",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983757457",
            "telephone_number": "253-539-6078",
            "fax_number": "253-539-6045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15214 CANYON RD E STE 120",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983757457",
            "telephone_number": "253-539-6078",
            "fax_number": "253-539-6045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AWAI",
        "first_name": "IAN",
        "middle_name": "KEAUPUNI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-03",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "HI",
            "license": "AMD-1033",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61491021",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA61491021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2273642",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "iawai612367@fhsce.catholichealth.net",
            "affiliation": "Y",
            "affiliationName": "Franciscan Medical Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "15214 Canyon Rd E Ste 120",
            "city": "Puyallup",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983757457",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Medical Physician Assistant in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Medical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.