Individual provider Active NPI

Kevin Bradley Kern

  • Anesthesiology Physician
  • Honolulu, HI
National Provider Identifier
1982636064
Registry record updated Oct 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD-11418 Issued in HI
Practice address
1360 S Beretania St
#215
Honolulu, HI 96814-1520
Phone
(808) 532-3711
Fax
(808) 532-3713
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD-11418 HI Primary

Addresses

Primary practice location

1360 S Beretania St
#215
Honolulu, HI 96814-1520

Mailing address

PO Box 3270
Honolulu, HI 96801-3270
Phone (808) 538-3232

Other identifiers 3

IdentifierTypeStateIssuer
495996-01OtherACS
A013OtherCHAMPUS TRICARE
0000228098OtherHMSA

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
I20040216001004 HI Practitioner - AnesthesiologyPractitioner - Interventional Pain Management 5294620639 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Anesthesia Medical Group Inc Anesthesiology CurrentSince Jun 1, 2001 Accepting new patients
Hawaii Permanente Medical Group Inc CurrentSince Mar 4, 2012 Accepting new patients
Island Professional Anesthesia LLC Anesthesiology CurrentSince Jun 1, 2020 Accepting new patients

Locations

1190 Waianuenue Ave
Hilo, HI 96720
Phone (808) 932-3000

1360 S Beretania St
Ste 215
Honolulu, HI 96814
Phone (808) 532-3600

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

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

221 Mahalani St
Wailuku, HI 96793
Phone (808) 242-2290

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413849600000",
    "number": "1982636064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3270",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968013270",
            "telephone_number": "808-538-3232",
            "fax_number": "808-538-3220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 S BERETANIA ST",
            "address_2": "#215",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968141520",
            "telephone_number": "808-532-3711",
            "fax_number": "808-532-3713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERN",
        "first_name": "KEVIN",
        "middle_name": "BRADLEY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2014-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "HI",
            "license": "MD-11418",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACS",
            "identifier": "495996-01",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS TRICARE",
            "identifier": "A013",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "0000228098",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.