Unknown Individual – Emergency Medicine Physician, NPI 1851337174

Emergency Medicine Physician

Unknown Individual is a healthcare provider. based in Waianae, Hawaii. specializing in Emergency Medicine Physician. They hold a License No. MD4502 (HI). The NPI Number for Unknown Individual is 1851337174

Main info

Organization

Inactive

45 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1851337174

Phone

(904) 805-1300

Address

PO BOX 869

Deactivation Date

15 February 2023

Doctor Profile

Medical School Name

UNIVERSITY OF HAWAII JOHN A. BURNS SCHOOL OF MEDICINE

Secondary Phone

8087420999

Graduation Year

1981 (45 years ago)

PAC ID

1456392513

Group Practice PAC ID

4688908924

Professional Enrollment ID

I20050518001110

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience14

Completeness75

Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

PO BOX 869
WAIANAE, HI 967920869
Phone: (904) 805-1300
Fax: (904) 805-1302
Type: Mailing
4643 WAIMEA CANYON RD
WAIMEA, HI 96796
Phone: (904) 805-1300
Fax: (904) 805-1302
Type: Location

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.

No Medicare enrollment or revalidation data available for this provider in our database.

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 96792)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.

PAC ID: 4688908924View full group profile