Individual provider Active NPI

Tia Pilikian, PA-C

  • Physician Assistant
  • Wailuku, HI
National Provider Identifier
1952885261
Registry record updated Feb 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
AMD-987 Issued in HI
Practice address
1830 Wells St Ste 101
Wailuku, HI 96793-2365
Phone
(808) 856-4060
Fax
(808) 442-9670
NPI assigned
Sep 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X AMD-987 HI Primary

Addresses

Primary practice location

1830 Wells St Ste 101
Wailuku, HI 96793-2365

Mailing address

1830 Wells St Ste 101
Wailuku, HI 96793-2365
Phone (808) 856-4060

Other practice location 1

221 Mahalani St
Wailuku, HI 96793-2526
Phone (808) 244-9056

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
I20210624002180 HI Practitioner - Physician Assistant 8022362284 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maui Trauma Surgeons LLPGroup PAC ID 9537555610, 7 clinicians

Practice addresses (Care Compare)

1830 Wells St
Suite 101
Wailuku, HI 96793-2365
Phone (808) 856-4060

221 Mahalani St
Wailuku, HI 96793-2526
Phone (805) 856-4060

National Provider Directory

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

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": "1537488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1952885261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 WELLS ST STE 101",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967932365",
            "telephone_number": "808-856-4060",
            "fax_number": "808-442-9670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 WELLS ST STE 101",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967932365",
            "telephone_number": "808-856-4060",
            "fax_number": "808-442-9670"
        }
    ],
    "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"
        }
    ],
    "basic": {
        "last_name": "PILIKIAN",
        "first_name": "TIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-21",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "HI",
            "license": "AMD-987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wailuku, HI

Sources for this page

Verify at the official NPI Registry.