MALIA RUSSO
NPI 1417446402
Physician Assistant in Honolulu, HI

Q: What is Malia Russo's NPI number?

The NPI number for Malia Russo is 1417446402. It was assigned to this individual provider in the NPPES registry on May 4, 2018.

Q: What is Malia Russo's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Malia Russo was last updated on March 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since May 04, 2018PECOS EnrolledAccepts Medicare Assignment

1401 S BERETANIA ST STE 102, HONOLULU, HI 96814(808) 356-5699 Get Directions Write a Review

NPPES record last updated: March 5, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 5, 2026, May 4, 2018 (2 updates tracked since 2018).

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About Malia Russo NPPES

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

MALIA RUSSO (NPI 1417446402) is an individual physician assistant in Honolulu, Hawaii, licensed in Hawaii (AMD1425) and active in the NPI registry since May 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1417446402

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameMALIA RUSSO

Location Address1401 S BERETANIA ST STE 102Honolulu, HI 96814-1871

Mailing Address2324 Kaala StHonolulu, HI 96822-2201 · (702) 501-1848

Phone(808) 356-5699

Sole ProprietorNo

Medical School CMSOtherGraduated 2024

Enumeration DateMay 4, 2018

Last NPPES UpdateMarch 5, 20262 updates tracked since enumeration

NPPES CertifiedMarch 5, 2026

✔ NPI 1417446402 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in HI · AMD1425

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

1401 S BERETANIA ST STE 102, Honolulu, HI 96814

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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

Malia Russo 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 ID5597280388

PECOS Enrollment IDI20250414003411

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 96814 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.

Other Providers at the Same Location NPPES 11

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

SHAYLEE JO CAULKINS PA-C

Physician Assistant