NPIMap

Individual provider Active NPI

Douglas J. Rose, M.D.

  • Family Medicine Physician
  • Hilo, HI
National Provider Identifier
1003892027
Registry record updated May 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
18758 Issued in HI
Practice address
45 Mohouli St
Hilo, HI 96720-7210
Phone
(808) 932-3740
NPI assigned
Dec 21, 2005
Last updated
May 30, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 18758 HI Primary

Addresses

Primary practice location

45 Mohouli St
Hilo, HI 96720-7210

Mailing address

1091 Apono PL
Hilo, HI 96720-2701
Phone (423) 341-5473

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160909002491 HI Practitioner - Family Practice 6507888112 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Jefferson Medical College of Thomas Jefferson University, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kau HospitalGroup PAC ID 7416945548, 138 clinicians
Hilo Benioff Medical CenterGroup PAC ID 1254422900, 131 clinicians

Practice addresses (Care Compare)

1 Kamani St
Pahala, HI 96777
Phone (808) 932-4370

1190 Waianuenue Ave
Hilo, HI 96720-2089
Phone (808) 932-3000

45 Mohouli St
Hilo, HI 96720-7210
Phone (808) 932-4215

PO Box
Pahala, HI 96777

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
18758HIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kau Hospital CurrentSince Mar 1, 2020 Accepting new patients
Hilo Benioff Medical Center CurrentSince Aug 10, 2016 Accepting new patients
Kau Hospital CurrentSince Mar 1, 2020 Accepting new patients
Hilo Benioff Medical Center CurrentSince Aug 10, 2016 Accepting new patients
Medical Education Assistance Corporation Family Medicine Past Accepting new patients
Hilo Benioff Medical Center Past Accepting new patients

Locations

1190 Waianuenue Ave
Hilo, HI 96720
Phone (808) 932-3000

Networks

  • HI PPO

Interoperability endpoints

  • Direct secure messaging: drose21316@hhsc.direct-ci.com

Organizations & group practices 6

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748563200000",
    "number": "1003892027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1091 APONO PL",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967202701",
            "telephone_number": "423-341-5473",
            "fax_number": "888-960-2830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 MOHOULI ST",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967207210",
            "telephone_number": "808-932-3740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "DOUGLAS",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-21",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "HI",
            "license": "18758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilo, HI

Sources for this page

Verify at the official NPI Registry.