Individual provider Active NPI

Justin Ody, PA-C

  • Medical Physician Assistant
  • Kihei, HI
National Provider Identifier
1922424688
Registry record updated Mar 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
AMD-553 Issued in HI
Practice address
221 Piikea Ave
Suite a
Kihei, HI 96753-8268
Phone
(808) 874-8100
Fax
(808) 874-6887
NPI assigned
Mar 5, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2014

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-553 HI Primary

Addresses

Primary practice location

221 Piikea Ave
Suite a
Kihei, HI 96753-8268

Mailing address

221 Piikea Ave
Suite a
Kihei, HI 96753-8268
Phone (808) 874-8100

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
I20140707001524 HI Practitioner - Physician Assistant 1557586526 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kihei-Wailea Medical Center. LLCGroup PAC ID 9739070459, 9 clinicians

Practice addresses (Care Compare)

221 Piikea Ave
Kihei, HI 96753-8268
Phone (808) 874-8100

221 Piikea Ave a
Kihei, HI 96753-8268

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AMD-553HIMDMedical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: justin.ody@22487299391492.direct.elationemr.com

Organizations & group practices 1

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": "1393977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393977600000",
    "number": "1922424688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 PIIKEA AVE",
            "address_2": "SUITE A",
            "city": "KIHEI",
            "state": "HI",
            "postal_code": "967538268",
            "telephone_number": "808-874-8100",
            "fax_number": "808-874-6887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 PIIKEA AVE",
            "address_2": "SUITE A",
            "city": "KIHEI",
            "state": "HI",
            "postal_code": "967538268",
            "telephone_number": "808-874-8100",
            "fax_number": "808-874-6887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODY",
        "first_name": "JUSTIN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-05",
        "last_updated": "2014-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "HI",
            "license": "AMD-553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kihei, HI

Sources for this page

Verify at the official NPI Registry.