PANIOLO PEDIATRIC AND FAMILY MEDICINE INC - NPI 1053812990

Q: What is the provider's specialty?

The provider's specialty is Pediatrics with taxonomy code 208000000X.

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About Paniolo Pediatric And Family Medicine Inc NPPES

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

PANIOLO PEDIATRIC AND FAMILY MEDICINE INC (NPI 1053812990) is a healthcare organization registered as a pediatrics in Kamuela, Hawaii and active in the NPI registry since February 2018. The organization holds 3 active CLIA laboratory certificates, maintains a secondary practice location in Kailua Kona, and lists Brett C. Ferguson, President, as its authorized official.

NPPES Registry Identity

NPI1053812990

Entity TypeOrganization

Primary Taxonomy208000000X

Legal Business NamePANIOLO PEDIATRIC AND FAMILY MEDICINE INC

Location Address64-1032 MAMALAHOA HWY STE 204Kamuela, HI 96743-8441

Mailing AddressPo Box 6149Kamuela, HI 96743-6149 · (808) 887-6543 · Fax (808) 887-6294

Phone(808) 887-6543

Fax(808) 887-6294

Organization SubpartNo

Authorized OfficialBrett C. FergusonPresident · (808) 887-6543

Enumeration DateFebruary 26, 2018

Last NPPES UpdateMarch 17, 20182 updates tracked since enumeration

✔ NPI 1053812990 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in HI · MD16732

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Also ListedFamily MedicineTaxonomy 207Q00000X · License MD18820 (HI)

64-1032 MAMALAHOA HWY STE 204, Kamuela, HI 96743

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Secondary Practice Location 1

Location 175-170 Hualalai Rd Ste D214Kailua Kona, HI 96740-1780 · Phone (808) 325-5805 · Fax (808) 657-4796

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

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

CLIA Laboratory Certificates CMS CLIA 3

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 12D2097582

Paniolo Pediatric And Family Medicine, Inc · Kamuela, HI

Active · expires Jun 17, 2027

CLIA Number12D2097582

Laboratory TypePhysician Office

Certificate Effective DateJune 18, 2025

Certificate Expiration DateJune 17, 2027

Laboratory DirectorDr. Azriel Dror

Laboratory Phone(808) 887-6543

Laboratory LocationPaniolo Pediatric And Family Medicine, Inc64-1032 Mamalahoa Hwy, Suite 204, Kamuela, HI 96743

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 12D2120235

Paniolo Pediatric And Family Medicine, Inc · Kailua Kona, HI

Active · expires Oct 11, 2026

CLIA Number12D2120235

Laboratory TypePhysician Office

Certificate Effective DateOctober 12, 2024

Certificate Expiration DateOctober 11, 2026

Laboratory DirectorDr. Azriel Dror

Laboratory Phone(808) 325-5805

Laboratory LocationPaniolo Pediatric And Family Medicine, Inc75-170 Hualalai Rd Suite D-214, Kailua Kona, HI 96740

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 12D2165270

Paniolo Pediatric And Family Medicine, Inc · Kamuela, HI

Active · expires Apr 22, 2027

CLIA Number12D2165270

Laboratory TypePhysician Office

Certificate Effective DateApril 23, 2025

Certificate Expiration DateApril 22, 2027

Laboratory DirectorDr. Azriel Dror

Laboratory Phone(808) 885-1878

Laboratory LocationPaniolo Pediatric And Family Medicine, Inc64-1032 Mamalahoa Hwy, Suite 201, Kamuela, HI 96743

CLIA data matches this NPI record on: Name

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

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

PANIOLO COUNTRY PEDIATRICS LLC

Pediatrics