RONNIE TREVOR OTIENO (DO) – Family Medicine Physician, NPI 1760063739
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
514 FAMILY PRACTICE in HI
Provider Addresses for RONNIE TREVOR OTIENO (DO)
94-673 Kupuohi St
Waipahu, HI 967975367
Phone: (808) 439-6201
Type: Location
33 W TAMARISK ST
PHOENIX, AZ 850412422
Phone: (602) 406-3152
Type: Mailing
1441 KAPIOLANI BLVD STE 2020
HONOLULU, HI 968144408
Phone: (808) 439-6201
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-07-16
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240906002259 | I | Family Practice | NC | TBD |
| I20250716001682 | I | Family Practice | HI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 96797)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | HI | |
| Physical Therapist In Private Practice | HI | |
| Orthopedic Surgery | HI |
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