John Joseph Reidelbach II, PA-C

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1171933 Issued in HI

Practice address

683 Waianae Ave BLDG G 1St Floor, Ste a
Schofield Barracks, HI 96786

Phone

(808) 433-8475

NPI assigned

Jun 15, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: john.reidelbach@45970684706820.direct.elationemr.com

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.

• Waianae District Comprehensive Health and Hospital Board, Inc

  • Family Medicine Physician
  • Waianae, HI
  • NPI 1275566424
  Medicare reassignment

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

{
    "created_epoch": "1592179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1982229993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "683 WAIANAE AVE BLDG G 1ST FLOOR, STE A",
            "city": "SCHOFIELD BARRACKS",
            "state": "HI",
            "postal_code": "96786",
            "telephone_number": "808-433-8475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "683 WAIANAE AVE BLDG G 1ST FLOOR, STE A",
            "city": "SCHOFIELD BARRACKS",
            "state": "HI",
            "postal_code": "96786",
            "telephone_number": "808-433-8475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REIDELBACH",
        "first_name": "JOHN",
        "middle_name": "JOSEPH",
        "name_suffix": "II",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-15",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "1171933",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "HI",
            "license": "1171933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela Grace Peros, LCSW, QCSW
• Cherie Peterson, PHARM.D.
• Benjamin Floyd Platt, D.O.
• James Roland Pronath, LCSW
• Susan Kathleen Ramirez, RN
• Thomas James Rogers, M.D.
• Don L Rooks, LCSW-A
• Tracey Lynne Ross
• Fiorela Ruiz, LCSW
• Zachary D Russell, DDS

• Family Medicine Physician in Schofield Barracks, HI
• Providers in Schofield Barracks, HI by specialty
• Family Medicine Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.