Individual provider Active NPI

Chasen Daugherty, PA-C

  • Orthopaedic Surgery Physician
  • Honolulu, HI
National Provider Identifier
1952907008
Registry record updated Nov 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
AMD-1049 Issued in HI
Practice address
1401 S Beretania St Ste 102
Honolulu, HI 96814-1871
Phone
(808) 356-5699
NPI assigned
Dec 4, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X LKJ HI
Medical Physician Assistant 363AM0700X
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X AMD-1049 HI Primary

Addresses

Primary practice location

1401 S Beretania St Ste 102
Honolulu, HI 96814-1871

Mailing address

1401 S Beretania St Ste 102
Honolulu, HI 96814-1871
Phone (808) 356-5699

Other identifiers 1

IdentifierTypeStateIssuer
AMD-1049OtherHISTATE OF HAWAII

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
I20210813000226 HI Practitioner - Physician Assistant 1759785751 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
All Access Ortho Oahu LLCGroup PAC ID 9638618499, 20 clinicians

Practice addresses (Care Compare)

1401 S Beretania St
Honolulu, HI 96814-1871
Phone (808) 356-5699

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LKJHIMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Services Company, LLP CurrentSince Aug 1, 2021 Accepting new patients

Locations

1401 S Beretania St
Ste 750
Honolulu, HI 96814
Phone (808) 521-8183

Organizations & group practices 3

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": "1607040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1952907008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 S BERETANIA ST STE 102",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968141871",
            "telephone_number": "808-356-5699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S BERETANIA ST STE 102",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968141871",
            "telephone_number": "808-356-5699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUGHERTY",
        "first_name": "CHASEN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-04",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "HI",
            "license": "LKJ",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "HI",
            "license": "AMD-1049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF HAWAII",
            "identifier": "AMD-1049",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.