Alysha Delphine Enbom, is a medicare enrolled "Nurse Practitioner - Family" in Hanapepe, Hawaii. Her current practice location is
Po Box 624, Hanapepe, Hawaii. You can reach out to her office (for appointments etc.) via phone at
(360) 301-5568.
Alysha Delphine Enbom is licensed to practice in Hawaii (license number APRN-4642) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1457100299.
Provider's Profile
| Full Name | Alysha Delphine Enbom |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | Po Box 624, Hanapepe, Hawaii |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1457100299
- Provider Enumeration Date: 05/15/2024
- Last Update Date: 06/26/2024
Medicare PECOS Information:
- PECOS PAC ID: 9436698594
- Enrollment ID: I20240903003490
Medical Identifiers
Medical identifiers for Alysha Delphine Enbom such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1457100299 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 163W00000X | Registered Nurse | 55667 (Idaho) | Secondary |
| 163W00000X | Registered Nurse | RN61092439 (Washington) | Secondary |
| 163W00000X | Registered Nurse | 103027 (Hawaii) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | APRN-4642 (Hawaii) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Alysha Delphine Enbom allows following entities to bill medicare on her behalf.
| Entity Name | Straub Clinic & Hospital |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1457306508 PECOS PAC ID: 6305759754 Enrollment ID: O20031111000417 |
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| Entity Name | Kauai Medical Clinic |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1376596643 PECOS PAC ID: 5092628479 Enrollment ID: O20031111000540 |
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| Entity Name | Hoola Lahui Hawaii |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1245269976 PECOS PAC ID: 2860303021 Enrollment ID: O20031226000260 |
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| Entity Name | Kapiolani Medical Center For Women & Children |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1548215692 PECOS PAC ID: 9830097914 Enrollment ID: O20031229000149 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Alysha Delphine Enbom is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Alysha Delphine Enbom, Po Box 624, Hanapepe, HI 96716-0624 Ph: (360) 301-5568 | Alysha Delphine Enbom, Po Box 624, Hanapepe, HI 96716-0624 Ph: (360) 301-5568 |
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