Individual provider Active NPI

Brock J. K. Kaya

  • Anatomic Pathology & Clinical Pathology Physician
  • Honolulu, HI
National Provider Identifier
1972557684
Registry record updated May 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
10721 Issued in HI
Practice address
3288 Moanalua Rd
Honolulu, HI 96819-1469
Phone
(808) 432-0000
NPI assigned
May 19, 2006
Last updated
May 10, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 10721 HI Primary

Addresses

Primary practice location

3288 Moanalua Rd
Honolulu, HI 96819-1469

Mailing address

3288 Moanalua Rd
Honolulu, HI 96819-1469
Phone (808) 432-0000

Other identifiers 1

IdentifierTypeStateIssuer
0049918801MedicaidHI

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/interconnect-prodhim/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110808000511 HI Practitioner - Pathology 6507035557 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Hawaii John a. Burns School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hawaii Pathologists LaboratoryGroup PAC ID 4880585876, 16 clinicians
Hawaii Permanente Medical Group IncGroup PAC ID 7618880667, 705 clinicians

Practice addresses (Care Compare)

1301 Punchbowl St
Honolulu, HI 96813-2402
Phone (808) 691-4271

3288 Moanalua Rd
Honolulu, HI 96819-1469
Phone (808) 432-0000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.75 of 100Reported as group
Quality
75
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
10721HIMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hawaii Pathologists' Laboratory Anatomic Pathology & Clinical Pathology CurrentSince Mar 1, 2020 Accepting new patients
Hawaii Permanente Medical Group Inc CurrentSince May 19, 2017 Accepting new patients
Hawaii Pathologists' Laboratory Past Accepting new patients

Locations

1301 Punchbowl St
Honolulu, HI 96813
Phone (808) 538-9011

1301 Punchbowl St
Fl 4
Honolulu, HI 96813
Phone (808) 547-4271

3288 Moanalua Rd
Honolulu, HI 96819
Phone (808) 265-9205

702 S Beretania St
Ste B100
Honolulu, HI 96813
Phone (808) 538-2701

711 Kapiolani Blvd
Honolulu, HI 96813
Phone (808) 432-5312

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1972557684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3288 MOANALUA RD",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968191469",
            "telephone_number": "808-432-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3288 MOANALUA RD",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968191469",
            "telephone_number": "808-432-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAYA",
        "first_name": "BROCK",
        "middle_name": "J. K.",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "HI",
            "license": "10721",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0049918801",
            "state": "HI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodhim/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3288 Moanalua Rd",
            "city": "Honolulu",
            "state": "HI",
            "country_code": "US",
            "postal_code": "968191469",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.