Active NPI
Imtiaz Hussain Bangash, MD
- Hospitalist Physician
- Honolulu, HI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- MD-24060
- Practice address
- 1301 Punchbowl St
Honolulu, HI 96813-2499 - Phone
- (808) 691-1000
- NPI assigned
- Aug 28, 2014
- Last updated
- Feb 22, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | CDR.0002708 | KS | |
| Hospitalist Physician | 208M00000X | 036143032 | IL | |
| Hospitalist Physician | 208M00000X | MD-24060 | HI | Primary |
Addresses
Primary practice location
1301 Punchbowl St
Honolulu, HI 96813-2499
Mailing address
1301 Punchbowl St
Honolulu, HI 96813-2499
Phone (808) 691-1000
Other practice location 1
1800 E Lake Shore Dr
Decatur, IL 62521-3810
Phone (217) 464-5811
Other practice location 2
4500 Memorial Dr
Belleville, IL 62226-5360
Phone (618) 257-6220
Other practice location 3
401 E Spruce St
Garden City, KS 67846-5679
Phone (620) 272-2222
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ibangash157628@ewd.direct.hshs.org | Direct | |
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, VI, HI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- General Practice
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1301 Punchbowl St
Honolulu, HI 96813-2499
1380 Lusitana St
Honolulu, HI 96813-2448
67-1125 Mamalaho Hwy
Kamuela, HI 96743-8496
Phone (808) 885-4444
91 -2127 Fort Weaver Rd
Ewa Beach, HI 96706-1993
Phone (808) 691-3000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CDR.0002708 | KS | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Midpacific Hospitalists LLC | Current | Accepting new patients | |
| Fairview Heights Medical Group SC | Current | Accepting new patients | |
| Fairview Heights Medical Group SC | Current | Accepting new patients | |
| Governor Juan F. Luis Hospital & Medical Center | Current | Accepting new patients | |
| Queens University Medical Group | Current | Accepting new patients | |
| Governor Juan F. Luis Hospital & Medical Center | Current | Accepting new patients | |
| Queens North Hawaii Community Hospital | Past | Accepting new patients | |
| Hawaii Emergency Physicians Associated Inc | Past | Accepting new patients |
Locations
1301 Punchbowl St
Honolulu, HI 96813
Phone (808) 538-9011
1380 Lusitana St
Ste 913
Honolulu, HI 96813
Phone (808) 691-8521
67-1125 Mamalahoa Hwy
Kamuela, HI 96743
Phone (808) 881-4400
1 Memorial Dr
Alton, IL 62002
Phone (618) 463-7240
4500 Memorial Dr
Belleville, IL 62226
Phone (618) 233-7750
4007 Estate Diamond Ruby
St Croix, VI 00820
Phone (340) 772-7423
Networks
- IL PPO Downstate
- devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
- devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
- IL HMO C-SNP
- devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806
Interoperability endpoints
- ibangash157628@ewd.direct.hshs.org
Organizations & group practices 8
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Internal Medicine Physician
- Kailua, HI
- NPI 1053778217
-
- Multi-Specialty Clinic/Center
- Honolulu, HI
- NPI 1891441382
-
- General Acute Care Hospital
- Christiansted, St. Croix, VI
- NPI 1972503647
-
dba BJC Medical Group of Illinois
- Multi-Specialty Clinic/Center
- Saint Louis, MO
- NPI 1073022000
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- St Croix, VI
- NPI 1740238534
-
dba HEPA, Inc.
- Emergency Medicine Physician
- Kailua, HI
- NPI 1801843198
-
- General Acute Care Hospital
- Kamuela, HI
- NPI 1477559029
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Honolulu, HI
- NPI 1184612764
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1409184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708560000000",
"number": "1003216953",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1301 PUNCHBOWL ST",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968132499",
"telephone_number": "808-691-1000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 PUNCHBOWL ST",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968132499",
"telephone_number": "808-691-1000"
}
],
"practiceLocations": [
{
"address_1": "1800 E Lake Shore Dr",
"address_purpose": "LOCATION",
"city": "Decatur",
"state": "IL",
"postal_code": "625213810",
"country_code": "US",
"telephone_number": "217-464-5811",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4500 Memorial Dr",
"address_purpose": "LOCATION",
"city": "Belleville",
"state": "IL",
"postal_code": "622265360",
"country_code": "US",
"telephone_number": "618-257-6220",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "401 E Spruce St",
"address_purpose": "LOCATION",
"city": "Garden City",
"state": "KS",
"postal_code": "678465679",
"country_code": "US",
"telephone_number": "620-272-2222",
"fax_number": "620-272-2755",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BANGASH",
"first_name": "IMTIAZ",
"middle_name": "HUSSAIN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-08-28",
"last_updated": "2024-02-22",
"certification_date": "2024-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "KS",
"license": "CDR.0002708",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "IL",
"license": "036143032",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "HI",
"license": "MD-24060",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ibangash157628@ewd.direct.hshs.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/CCD/TXT",
"address_1": "1800 E Lake Shore Dr",
"city": "Decatur",
"state": "IL",
"country_code": "US",
"postal_code": "625213810",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"endpointDescription": "BJC",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "4500 Memorial Dr",
"city": "Belleville",
"state": "IL",
"country_code": "US",
"postal_code": "622265360",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Honolulu, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.