CDR Plastic Surgery, Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

License

MD12235 Issued in HI

Legal business name

CDR PLASTIC SURGERY, INC.

Practice address

1380 Lusitana St Ste 904
Honolulu, HI 96813-2448

Phone

(808) 525-6590

Fax

(808) 599-8801

NPI assigned

Mar 8, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Carl Legaspi De Los Reyes, M.D.NPI 1164531216

Title

President

Phone

(808) 525-6590

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in HI

Enrollment records 1

Locations

Interoperability endpoints

• Direct secure messaging: carl.delosreyes@hawaiihie.medicity.net

Practitioners 5

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

• Carl Legaspi Delos Reyes, M.D.

  • Plastic Surgery Physician
  • Honolulu, HI
  • NPI 1164531216
  Medicare reassignment NPD Authorized official
• Alan Parsa, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Honolulu, HI
  • NPI 1215268362

  Single Specialty

  NPD (past)
• Fereydoun D. Parsa, M.D.

  • Surgery Physician
  • Honolulu, HI
  • NPI 1164505913
  NPD (past)
• Natalie Niloufar Parsa, M.D.

  • Family Medicine Physician
  • Honolulu, HI
  • NPI 1366646275
  NPD (past)
• Jessica Kiersten Mattson, PA-C

  • Medical Physician Assistant
  • Roseville, CA
  • NPI 1669637807
  NPD (past)

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003947474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4470 SIERRA DR",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968164022",
            "telephone_number": "808-525-6590",
            "fax_number": "808-599-8801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 LUSITANA ST STE 904",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132448",
            "telephone_number": "808-525-6590",
            "fax_number": "808-599-8801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CDR PLASTIC SURGERY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DE LOS REYES",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "LEGASPI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "808-525-6590",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "HI",
            "license": "MD12235",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "53476002",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberlee Gaye Cayzer, MS
• Kathy S.L. Cazares, MD
• Antoine Jean Cazin, M.D.
• Jane Ccaihuari Vigil, MSW
• CCK Daniel LLC
• CDS Inc.
• Cec Eye Center LLC
• Nicole Ann Cecchi
• Cecil Riter DDS, Inc
• Cecil Riter DDS. Inc

• Specialist in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Specialist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.