| Project Vision Hawaii | |
|
810 N Vineyard Blvd Bldg B Honolulu HI 96817-3590 | |
| (808) 201-3937 | |
| (833) 941-2390 |
| Full Name | Project Vision Hawaii |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 810 N Vineyard Blvd Bldg B, Honolulu, Hawaii |
| Authorized Official Name and Position | Darrah Kauhane-floerke (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8083064406 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Project Vision Hawaii Po Box 23212 Honolulu HI 96823-3212 Ph: (808) 201-3937 | Project Vision Hawaii 810 N Vineyard Blvd Bldg B Honolulu HI 96817-3590 Ph: (808) 201-3937 |
| NPI Number | 1629534268 |
|---|---|
| Provider Enumeration Date | 02/19/2019 |
| Last Update Date | 05/15/2024 |
| Certification Date | 09/14/2021 |
| Medicare PECOS PAC ID | 1052744174 |
|---|---|
| Medicare Enrollment ID | O20191204000743 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629534268 | NPI | - | NPPES |
| 57683701 | Medicaid | HI |
| Provider Name | Vijak S Ayasanonda |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1346285582 PECOS PAC ID: 0244271278 Enrollment ID: I20050519000428 |
| Provider Name | Jeffrey Peterson |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1578889945 PECOS PAC ID: 7719289164 Enrollment ID: I20151231001682 |
| Provider Name | Rae Lynne Lahela Newpher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538864699 PECOS PAC ID: 2860856739 Enrollment ID: I20230911002475 |
| Provider Name | Kevin Joseph Kathman |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1093999757 PECOS PAC ID: 6901988583 Enrollment ID: I20240419001118 |
| Provider Name | Robin Lisa Garrison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508493834 PECOS PAC ID: 1850732835 Enrollment ID: I20240508000787 |
| Provider Name | Teresa Anne Kiresuk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093750499 PECOS PAC ID: 1355478827 Enrollment ID: I20240611003790 |
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