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DOUGLAS K BIRCH D.P.M.
NPI 1033113071
Podiatrist in Kahului, HI

Active since June 08, 2005PECOS EnrolledAccepts Medicare Assignment
75/100
CMS Quality Rating
415 DAIRY RD, STE D, KAHULUI, HI 96732(808) 877-3668(808) 877-3248 Get Directions Write a Review

NPPES record last updated: April 30, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Douglas K Birch D.p.m. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DOUGLAS K BIRCH D.P.M. (NPI 1033113071) is an individual podiatrist in Kahului, Hawaii, licensed in Hawaii (PO-168) and active in the NPI registry since June 2005. He is enrolled in Medicare PECOS, is affiliated with Maui Memorial Medical Center, and is a graduate of California School Of Podiatric Medicine (2001).

NPPES Registry Identity

NPI1033113071
Entity TypeIndividualMale
Primary Taxonomy213E00000X
Provider Legal NameDOUGLAS K BIRCHCredential: D.P.M.
Location Address415 DAIRY RD, STE DKahului, HI 96732-2348
Mailing Address415 Dairy Rd, Ste DKahului, HI 96732-2348 · (808) 877-3668 · Fax (808) 877-3248
Phone(808) 877-3668
Fax(808) 877-3248
Sole ProprietorNo
Medical School CMSCalifornia School Of Podiatric MedicineGraduated 2001
Enumeration DateJune 8, 2005
Last NPPES UpdateApril 30, 2020
NPPES CertifiedApril 30, 2020
✔ NPI 1033113071 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatristPodiatric Medicine & Surgery Service Providers
Taxonomy Code213E00000X
License✔ Licensed in HI · PO-168
Definition
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.
415 DAIRY RD, Kahului, HI 96732
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Other Identifiers 1

Medicaid54589001HI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HMSA.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Douglas K Birch D.p.m. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2365334877
PECOS Enrollment IDI20040329000953
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 7

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
1,064 services386 patients
Removal of fingernails or toenails, 6 or more nails 11721
This procedure involves the removal of six or more fingernails or toenails. It's typically done to treat severe nail infections, persistent pain, or abnormal nail growth. Local anesthesia is used to minimize discomfort. Healing usually takes a few weeks.
301 services104 patients
X-ray of foot, minimum of 3 views 73630
An X-ray of the foot, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones and tissues in your foot. This helps to identify fractures, infections, or other abnormalities. Multiple views ensure a comprehensive examination.
181 services116 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
158 services158 patients
Removal of noncancer thickened skin growth, 2-4 growths 11056
This procedure involves the safe removal of 2-4 noncancerous thickened skin growths. It's typically done under local anesthesia. The process helps to alleviate discomfort and prevent potential complications. It's a standard, low-risk procedure.
71 services19 patients
Simple or single drainage of skin abscess 10060
A simple or single drainage of skin abscess is a procedure to remove pus from a skin infection. A small cut is made on the abscess, the pus is drained out, and the area is cleaned. This helps to reduce pain, speed up recovery, and prevent the spread of infection.
21 services18 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Maui Memorial Medical Center

Acute Care Hospitals · Wailuku, HI
3/5 CMS rating
OwnershipGovernment - State
CMS Certification Number120002
Location221 Mahalani StreetWailuku, HI 96793 · Maui County
Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 96732 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$92.50 typical visit price
range $60.53 – $180.05
Typical copayment $23.12 (range $15.13 – $45.01)
Most-billed visit code 99203
Established Patient
$74.92 typical visit price
range $20.09 – $147.56
Typical copayment $18.73 (range $5.02 – $36.89)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
90%780 patients4/55-star benchmark: 100%
Diabetes Mellitus: Diabetic Foot and Ankle Care, Peripheral Neuropathy - Neurological Evaluation
Percentage of patients aged 18 years and older with a diagnosis of diabetes mellitus who had a neurological examination of their lower extremities within 12 months
67%654 patients3/55-star benchmark: 100%
Diabetes Mellitus: Diabetic Foot and Ankle Care, Ulcer Prevention - Evaluation of Footwear
Percentage of patients aged 18 years and older with a diagnosis of diabetes mellitus who were evaluated for proper footwear and sizing
60%652 patients3/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
93%5,087 patients4/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
63%197 patients3/55-star benchmark: 100%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
15%120 patients1/55-star benchmark: 98%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
13%615 patients1/55-star benchmark: 100%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
12%110 patients1/55-star benchmark: 100%
Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling
Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user
79%1,015 patients4/55-star benchmark: 100%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
55%615 patients3/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf L4361
DME-Orthotic Devices · category DF003N
1 supplier12 claims12 services$201.07 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EAST WEST MEDICAL, INC.
Clinic/Center (Primary Care)
415 DAIRY RD, SUITE E-412
KAHULUI, HI 96732
Maui County (575) 613-4684
ALOHA FAMILY FOOTCARE LLC
Podiatrist
415 DAIRY RD, SUITE D
KAHULUI, HI 96732
Maui County (808) 877-3668

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Douglas Birch's NPI number?

The NPI number for Douglas Birch is 1033113071. It was assigned to this individual provider in the NPPES registry on June 8, 2005.

Where is Douglas Birch located?

Douglas Birch practices at 415 Dairy Rd Ste D, Kahului, HI 96732. The listed phone number is (808) 877-3668.

What is Douglas Birch's specialty?

The primary specialty registered for this NPI is Podiatrist with taxonomy code 213E00000X.

Is Douglas Birch enrolled in Medicare?

Yes. Douglas Birch is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Douglas Birch accept?

Health plans from HMSA list Douglas Birch as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Douglas Birch affiliated with any hospitals?

According to CMS data, Douglas Birch is affiliated with Maui Memorial Medical Center.

When was this NPI record last updated?

The NPPES record for Douglas Birch was last updated on April 30, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.