Alysha Delphine Enbom, is a medicare enrolled "Nurse Practitioner - Family" in Hanapepe, Hawaii. Her current practice location is
Po Box 624, Hanapepe, Hawaii. You can reach out to her office (for appointments etc.) via phone at
(360) 301-5568.
Alysha Delphine Enbom is licensed to practice in Hawaii (license number APRN-4642) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1457100299.
Provider's Profile
Full Name | Alysha Delphine Enbom |
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Gender | Female |
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Speciality | Nurse Practitioner - Family |
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Location | Po Box 624, Hanapepe, Hawaii |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1457100299
- Provider Enumeration Date: 05/15/2024
- Last Update Date: 06/26/2024
Medicare PECOS Information:
- PECOS PAC ID: 9436698594
- Enrollment ID: I20240903003490
Medical Identifiers
Medical identifiers for Alysha Delphine Enbom such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1457100299 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
163W00000X | Registered Nurse | 55667 (Idaho) | Secondary |
163W00000X | Registered Nurse | RN61092439 (Washington) | Secondary |
163W00000X | Registered Nurse | 103027 (Hawaii) | Secondary |
363LF0000X | Nurse Practitioner - Family | APRN-4642 (Hawaii) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Alysha Delphine Enbom allows following entities to bill medicare on her behalf.
Entity Name | Straub Clinic & Hospital |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1457306508 PECOS PAC ID: 6305759754 Enrollment ID: O20031111000417 |
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Entity Name | Kauai Medical Clinic |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1376596643 PECOS PAC ID: 5092628479 Enrollment ID: O20031111000540 |
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Entity Name | Hoola Lahui Hawaii |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1245269976 PECOS PAC ID: 2860303021 Enrollment ID: O20031226000260 |
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Entity Name | Kapiolani Medical Center For Women & Children |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1548215692 PECOS PAC ID: 9830097914 Enrollment ID: O20031229000149 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Alysha Delphine Enbom is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Alysha Delphine Enbom, Po Box 624, Hanapepe, HI 96716-0624 Ph: (360) 301-5568 | Alysha Delphine Enbom, Po Box 624, Hanapepe, HI 96716-0624 Ph: (360) 301-5568 |
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