MAKANA NORTH SHORE DERMATOLOGY
NPI 1356149892
Dermatology in Princeville, HI

Active since March 03, 2025
4488 HANALEI PLANTATION RD, PRINCEVILLE, HI 96722(808) 320-7300 Get Directions Write a Review

NPPES record last updated: June 2, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jun 2, 2025, Mar 3, 2025 (2 updates tracked since 2025).

About Makana North Shore Dermatology NPPES

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

MAKANA NORTH SHORE DERMATOLOGY (NPI 1356149892) is a healthcare organization registered as a dermatology in Princeville, Hawaii and active in the NPI registry since March 2025. The organization lists Edward Kimball, Sole Mbr, as its authorized official.

NPPES Registry Identity

NPI1356149892
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameMAKANA NORTH SHORE DERMATOLOGY
Location Address4488 HANALEI PLANTATION RDPrinceville, HI 96722-5462
Mailing Address4488 Hanalei Plantation RdPrinceville, HI 96722-5462 · (808) 320-7300
Organization SubpartNo
Authorized OfficialEdward KimballSole Mbr · (801) 910-1963
Enumeration DateMarch 3, 2025
Last NPPES UpdateJune 2, 20252 updates tracked since enumeration
NPPES CertifiedJune 2, 2025
✔ NPI 1356149892 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
4488 HANALEI PLANTATION RD, Princeville, HI 96722

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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Makana North Shore Dermatology is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

8

Medicare enrollment records show 8 clinicians reassign Medicare billing to Makana North Shore Dermatology, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (8)

Dermatology
NPI 1689692576
4488 HANALEI PLANTATION RD
Princeville, HI 96722
(808) 320-7300
✔ PECOS✔ Accepts Medicare0.4 mi
Dermatology
NPI 1558820944
30 N 1900 E # 4A330
Salt Lake City, UT 84132
(801) 581-6465
✔ PECOS3,041 mi
Dermatology
NPI 1831326941
25 W. 500 S
Bountiful, UT 84010
(801) 298-1514
✔ PECOS✔ Accepts Medicare3,043 mi
Dermatology
NPI 1770779050
UNIVERSITY OF UTAH DEPT OF 50 N MEDICAL DR
Salt Lake City, UT 84112
(801) 587-6340
✔ PECOS✔ Accepts Medicare3,044 mi
Dermatology
NPI 1477659746
50 N MEDICAL DR
Salt Lake City, UT 84132
(801) 581-2955
✔ PECOS✔ Accepts Medicare3,044 mi
Dermatology
NPI 1215181797
50 N MEDICAL DR
Salt Lake City, UT 84132
(801) 581-2955
✔ PECOS✔ Accepts Medicare3,044 mi
Dermatology
NPI 1811239148
30 N 1900 E 4A330 SCHOOL OF MEDICINE
Salt Lake City, UT 84132
(801) 581-6465
✔ PECOS✔ Accepts Medicare3,044 mi
Dermatology
NPI 1295173003
593 EDDY ST
Providence, RI 02903
(401) 444-7959
✔ PECOS5,123 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Makana North Shore Dermatology's NPI number?

The NPI number for Makana North Shore Dermatology is 1356149892. It was assigned to this organization in the NPPES registry on March 3, 2025.

Where is Makana North Shore Dermatology located?

Makana North Shore Dermatology is located at 4488 Hanalei Plantation Rd, Princeville, HI 96722. The listed phone number is (808) 320-7300.

What is Makana North Shore Dermatology's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Makana North Shore Dermatology enrolled in Medicare?

Yes. Makana North Shore Dermatology is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Makana North Shore Dermatology?

According to the CMS Revalidation Reassignment List (October 2026 release), 8 clinicians, all in Dermatology, reassign their Medicare billing to Makana North Shore Dermatology. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Makana North Shore Dermatology accept?

Health plans from HMSA list Makana North Shore Dermatology 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.

When was this NPI record last updated?

The NPPES record for Makana North Shore Dermatology was last updated on June 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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.