NPIMap

Organization Active NPI

Pacific Radiation Oncology LLC

  • Radiation Oncology Physician
  • Honolulu, HI
National Provider Identifier
1003851932
Registry record updated Sep 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
10717599 Issued in HI
Legal business name
PACIFIC RADIATION ONCOLOGY LLC
Practice address
2226 Liliha St Ste B2
Honolulu, HI 96817-1605
Phone
(808) 547-6881
Fax
(808) 744-6958
NPI assigned
Jun 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Marissa Muniz
Title
Business Manager
Phone
(808) 744-6187

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0001X 10717599 HI Primary

Addresses

Primary practice location

2226 Liliha St Ste B2
Honolulu, HI 96817-1605

Mailing address

2226 Liliha St Ste 210
Honolulu, HI 96817-1605
Phone (808) 744-6187

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040622001357 HI Part B Supplier - Clinic/Group Practice 6901881077 Receives reassigned benefits from 6 practitioners
Practice locations: Aiea, HI; Honolulu, HI

National Provider Directory

National Provider Directory

Locations

98-1005 Moanalua Rd
Spc 4010
Aiea, HI 96701
Phone (808) 628-5684

98-1005 Moanalua Rd
#4010
Aiea, HI 96701

2226 Liliha St
Ste 210
Honolulu, HI 96817
Phone (808) 744-6187

2226 Liliha St
Ste 300
Honolulu, HI 96817

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537920000000",
    "number": "1003851932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2226 LILIHA ST STE 210",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968171605",
            "telephone_number": "808-744-6187",
            "fax_number": "808-744-6958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2226 LILIHA ST STE B2",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968171605",
            "telephone_number": "808-547-6881",
            "fax_number": "808-744-6958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC RADIATION ONCOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-17",
        "last_updated": "2018-09-26",
        "status": "A",
        "authorized_official_last_name": "MUNIZ",
        "authorized_official_first_name": "MARISSA",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "808-744-6187"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": "HI",
            "license": "10717599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Sep 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.