ALFONSO F JIMENEZ (NPI# 1821290917) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821290917 |
| Entity Type | Organization |
| Organization Name | ALFONSO F JIMENEZ |
| Practice Address |
91-896 Makule Rd Suite 102 Ewa Beach HI 96706-2543 |
| Practice Telephone | 8086894414 |
| Practice Fax Number | 8086897115 |
| Mailing Telephone | 8086894414 |
| Mailing Fax Number | 8086897115 |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2008-08-26 |
| Authorized Official Name | ALFONSO F JIMENEZ (OWNER) |
| Authorized Official Telephone | 8086894414 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| HI | MEDICARE PROVIDER NUMBER | H54603 | 01 |
| HI | MEDICARE PROVIDER NUMBER | H54601 | 01 |
| HI | MEDICARE PROVIDER NUMBER | H54602 | 01 |
| Street Address |
91-896 MAKULE RD SUITE 102 |
| City | EWA BEACH |
| State | HI |
| Zip Code | 96706-2543 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992758015 | Macrina U Vicerra-jaena | Nurse Practitioner | 91-896 Makule Rd, Suite 102, Ewa Beach, HI 96706-2526 | 2006-05-18 |
| 1023376779 | Jacqueline Yvonne Chacon | Nurse Practitioner | 91-896 Makule Rd, Suite 102, Ewa Beach, HI 96706-2543 | 2012-05-01 |
| 1932212370 | Rachel Tortolini | Family Medicine | 91-896 Makule Rd, Suite 102, Ewa Beach, HI 96706-2543 | 2006-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922625516 | Alison Tolentino | Technician | 91-3633 Kauluakoko Street, Ewa Beach, HI 96706 | 2020-06-29 |
| 1851915722 | Sheree Cole Wilson | Social Worker | 6851 B 112th Street, Ewa Beach, HI 96706 | 2020-06-05 |
| 1811547144 | Madelyn Valenzuela | Technician | 91-1007 Napoona St., Ewa Beach, HI 96706 | 2019-09-18 |
| 1932761673 | Kina'ole Case Management Agency LLC | Case Management | 91-1163 Olowa Street Ewa Beach Hi 96706, Ewa Beach, HI 96706 | 2019-07-02 |
| 1952875049 | Vegafit Elite Fitness and Training | Family Medicine | 91-2131 Kaioli St, #3403, Ewa Beach, HI 96706 | 2019-01-11 |
| 1912470345 | Kristen Eiko Kane | Speech-Language Pathologist | 91-1561 Keaunui Dr, Ewa Beach, HI 96706 | 2019-01-08 |
| 1871069849 | Desiree Tricarico | Nurse Practitioner | 91-6390 Kapolei Pkwy, Suite 200, Ewa Beach, HI 96706 | 2018-10-17 |
| 1598251894 | Ewa Beach Dentists LLC | Clinic/Center | 105 Fort Weaver Road, Ste 105, Ewa Beach, HI 96706 | 2018-07-10 |
| 1427586833 | Alison Mcdonald Cameron | Marriage & Family Therapist | 6186a Ibis Ave, Ewa Beach, HI 96706 | 2017-05-30 |
| 1629528567 | Cindy Ann Holden | Contractor | 91755 B Fort Weaver Road, Ewa Beach, HI 96706 | 2016-10-04 |
| Find all providers in zip 96706 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164054763 | Primary Care Physician Enterprise LLC | Clinic/Center | 91-6390 Kapolei Pkwy, Ewa Beach, HI 96706 | 2020-02-11 |
| 1851647952 | Venture Medical 21 Inc | Clinic/Center | 91-896 Makule Rd Ste 102, Ewa Beach, HI 96706-2543 | 2012-07-26 |
| 1235324625 | Kubo and Bihis, LLC | Clinic/Center | 91-1401 Fort Weaver Rd, Ewa Beach, HI 96706-2253 | 2007-09-10 |
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| 1619500394 | Vitra Eyewear Group LLC | Clinic/Center | 2233 Kalakaua Ave # B111e, Honolulu, HI 96815-5200 | 2020-02-20 |
| 1063079036 | Kos Integrative Health, LLC | Clinic/Center | 1441 Kapiolani Blvd Ste 609, Honolulu, HI 96814-4403 | 2019-05-24 |
| 1952873408 | Hawaii Health Systems Corporation | Clinic/Center | 4643 Waimea Canyon Dr, Ste B, Waimea, HI 96796 | 2018-12-21 |
| 1073085528 | Hawaii Health Systems Corporation | Clinic/Center | 2829 Ala Kalanikuamaka St, Koloa, HI 96756 | 2018-12-21 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.