MICA CRISP APRN NPI 1568985646

Nurse Practitioner (Family) in Honolulu, HI

NPI 1568985646 Individual Male Years of Experience 5 Nurse Practitioner Family PECOS Enrolled Accepts Medicare Approved Payment

About MICA CRISP

Mica Crisp is a provider established in Honolulu, Hawaii and his medical specialization is nurse practitioner (family) with more than 5 years of experience. The NPI number of Mica Crisp is 1568985646 and was assigned on July 2017. The practitioner's primary taxonomy code is 363LF0000X with license number APRN-2694 (HI). The provider is registered as an individual and his NPI record was last updated 2 years ago.

A nurse practitioner (NP) like Mica Crisp Aprn is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.

Mica Crisp is enrolled in PECOS and is eligible to order or refer healthcare services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices

Mica Crisp is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data he has hospital affiliations with Tacoma General Allenmore Hospital.

NPI

1568985646

Provider Name MICA CRISP APRN
Provider Location Address1301 PUNCHBOWL ST HONOLULU, HI 96813
Provider Mailing Address1200 QUEEN EMMA ST APT 1602 HONOLULU, HI 96813
GenderMale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year2017
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date07-20-2017
Last Update Date10-22-2019


Primary Taxonomy

Taxonomy Code363LF0000X
ClassificationNurse Practitioner
TypePhysician Assistants & Advanced Practice Nursing Providers
SpecializationFamily
License No.APRN-2694
License StateHI

Business Address

MICA CRISP APRN
1301 PUNCHBOWL ST
HONOLULU, HI
ZIP 96813
Phone: (808) 691-1000

Get Directions


Mailing Address

MICA CRISP APRN
1200 QUEEN EMMA ST APT 1602
HONOLULU, HI
ZIP 96813
Phone: (206) 818-9239



Secondary Locations

91-2141 Fort Weaver Rd
Ewa Beach, HI 96706
(808) 691-3000
11020 19th Ave. SE
Everett, WA 98208
(800) 722-3009
700 Minor Ave
Seattle, WA 98104
(206) 386-2573

Medicare Participation

Registered in PECOS? Yes What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.
PECOS PAC ID2567728017
PECOS Enrollment IDI20171115003920, I20191202000627
Accepts Medicare Assignment? Yes "What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

Hospital Affiliations

Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Mica Crisp is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
TACOMA GENERAL ALLENMORE HOSPITAL315 S MLK JR WAY
TACOMA, WA 98405
(253) 403-1000Acute Care Hospitals500129

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyAP60774418WANo

Taxonomy Description: Not Available

Other Providers at the same location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1164402434DR. TAE RHO MD
Individual
Radiology (Neuroradiology)1301 PUNCHBOWL ST
HONOLULU, HI 96813
(808) 521-9551
1477523710DR. DONALD R BLAIR MD
Individual
Radiology (Diagnostic Radiology)1301 PUNCHBOWL ST
HONOLULU, HI 96813
(808) 521-9551
1235100884 BRIAN F ISSELL MD FACP
Individual
Internal Medicine (Hematology & Oncology)1301 PUNCHBOWL ST QUEENS MEDICAL CENTER
HONOLULU, HI 96813
(808) 538-9011
1396717690DR. CHUONG NGUYEN MD
Individual
Radiology (Vascular & Interventional Radiology)1301 PUNCHBOWL ST
HONOLULU, HI 96813
(808) 521-9551
1083680144 KELLI WILLIAMS FNP
Individual
Nurse Practitioner1301 PUNCHBOWL ST
HONOLULU, HI 96813
(808) 547-4669
1205885134RADIOLOGY ASSOCIATES, INC
Organization
Radiology (Diagnostic Radiology)1301 PUNCHBOWL ST
HONOLULU, HI 96813
(808) 521-9551
1326098740DR. JOHN L CIEPLY MD
Individual
Radiology (Diagnostic Radiology)1301 PUNCHBOWL ST
HONOLULU, HI 96813
(808) 521-9551
1245280510DR. JOHN D CHAN MD
Individual
Radiology (Diagnostic Radiology)1301 PUNCHBOWL ST
HONOLULU, HI 96813
(808) 521-9551
1588614523DR. CRAIG A HAMASAKI MD
Individual
Radiology (Diagnostic Radiology)1301 PUNCHBOWL ST
HONOLULU, HI 96813
(808) 521-9551
1528011806DR. DARREN P LUM M.D.
Individual
Radiology (Diagnostic Radiology)1301 PUNCHBOWL ST
HONOLULU, HI 96813
(808) 521-9551
1366496960DR. THOMAS REPPUN
Individual
Pathology (Anatomic Pathology & Clinical Pathology)1301 PUNCHBOWL ST 4TH FLOOR
HONOLULU, HI 96813
(808) 547-4271
1093769465DR. KIRK HIRATA
Individual
Pathology (Anatomic Pathology & Clinical Pathology)1301 PUNCHBOWL ST 4TH FLOOR
HONOLULU, HI 96813
(808) 547-4271
1225082449DR. PAMELA TAUCHI-NISHI
Individual
Pathology (Anatomic Pathology & Clinical Pathology)1301 PUNCHBOWL ST 4TH FLOOR
HONOLULU, HI 96813
(808) 547-4271
1285680900 MARJORIE S BERNICE APRN
Individual
Registered Nurse1301 PUNCHBOWL ST
HONOLULU, HI 96813
(808) 538-9011
1114973336DR. JOHN A. MISAILIDIS M.D.
Individual
Internal Medicine1301 PUNCHBOWL ST
HONOLULU, HI 96813
(808) 538-9011
1376599423DR. RYAN T MATSUO MD
Individual
Radiology (Diagnostic Radiology)1301 PUNCHBOWL ST
HONOLULU, HI 96813
(808) 521-9551
1376599431DR. GURDEV SINGH M.D.
Individual
Internal Medicine1301 PUNCHBOWL ST
HONOLULU, HI 96813
(808) 538-9011
1407803059MS. ROSE M. CLUTE APRN
Individual
Clinical Nurse Specialist (Psychiatric/Mental Health, Adult)1301 PUNCHBOWL ST
HONOLULU, HI 96813
(808) 538-9011
1174570485DR. JOHN G PEARCE MD
Individual
Radiology (Diagnostic Radiology)1301 PUNCHBOWL ST
HONOLULU, HI 96813
(808) 521-9551
1427005743DR. WESLEY KIM
Individual
Pathology (Anatomic Pathology & Clinical Pathology)1301 PUNCHBOWL ST 4TH FLOOR
HONOLULU, HI 96813
(808) 547-4271

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.