Island Family Surgical Care Center LLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

ISLAND FAMILY SURGICAL CARE CENTER LLC

Practice address

411 Huku Lii PL Ste 304
Kihei, HI 96753-7062

Phone

(808) 868-2277

Fax

(808) 439-6060

NPI assigned

Sep 12, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Stephanie Rose Yan, MD

Title

Member

Phone

(088) 682-2778

Specialties & licenses 3

Addresses

Electronic endpoints 3

Medicare fee-for-service enrollment

Enrolled in HI

Enrollment records 1

Locations

Interoperability endpoints

• Direct secure messaging: stephanie.yan@127980050907140.direct.elationemr.com

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stephanie Rose Beltran Yan

  • Surgery Physician
  • Kihei, HI
  • NPI 1710206180
  Medicare reassignment NPD

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

{
    "created_epoch": "1536710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609286400000",
    "number": "1912480237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 HUKU LII PL STE 304",
            "city": "KIHEI",
            "state": "HI",
            "postal_code": "967537062",
            "telephone_number": "808-868-2277",
            "fax_number": "808-439-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 HUKU LII PL STE 304",
            "city": "KIHEI",
            "state": "HI",
            "postal_code": "967537062",
            "telephone_number": "808-868-2277",
            "fax_number": "808-439-6060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "221 Mahalani St",
            "address_purpose": "LOCATION",
            "city": "Wailuku",
            "state": "HI",
            "postal_code": "967932526",
            "country_code": "US",
            "telephone_number": "808-244-9056",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3071 Pualei Cir Apt 301",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968154934",
            "country_code": "US",
            "telephone_number": "909-319-9188",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1830 Wells St Ste 103",
            "address_purpose": "LOCATION",
            "city": "Wailuku",
            "state": "HI",
            "postal_code": "967932365",
            "country_code": "US",
            "telephone_number": "808-866-5335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ISLAND FAMILY SURGICAL CARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-12",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A",
        "authorized_official_last_name": "YAN",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "ROSE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "088-682-2778",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Surgical Critical Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Trauma Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stephanie.yan@127980050907140.direct.elationemr.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1830 Wells St Ste 103",
            "city": "Wailuku",
            "state": "HI",
            "country_code": "US",
            "postal_code": "967932365",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stephanie.yan@127980050907140.direct.elationemr.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1830 Wells St Ste 103",
            "city": "Wailuku",
            "state": "HI",
            "country_code": "US",
            "postal_code": "967932365",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stephanie.yan@127980050907140.direct.elationemr.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "411 Huku Lii Pl Ste 304",
            "city": "Kihei",
            "state": "HI",
            "country_code": "US",
            "postal_code": "967537062",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Surgery Physician in Kihei, HI
• Providers in Kihei, HI by specialty
• Surgery Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2020; 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.