Jesse C. Maag, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD-12230 Issued in HI

Practice address

1292 Waianuenue Ave
Hilo, HI 96720-1228

Phone

(808) 934-4000

NPI assigned

Oct 12, 2006

Last updated

Oct 29, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in HI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446076800000",
    "number": "1013006196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1285 WAIANUENUE AVE",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967201209",
            "telephone_number": "808-934-3014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1292 WAIANUENUE AVE",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967201228",
            "telephone_number": "808-934-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAAG",
        "first_name": "JESSE",
        "middle_name": "C.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2015-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "HI",
            "license": "MD-12230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "555708-02",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA BILLING NUMBER",
            "identifier": "0000247676",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tazialynn Leilani Lynam, APRN
• Torrey Lynch
• Cynthia Ka'Apu Lyons, P.T.
• Carolyn Sheong Jun Ma, PHARMD
• Tiffany Ma, M.D., M.P.H
• Johnmar Florungco Mabuti, PHARMD
• Divine Macahito, RBT
• Deanna Macapulay
• Miranda Macauley, BCBA
• Agata Machado

• Family Medicine Physician in Hilo, HI
• Providers in Hilo, HI by specialty
• Family Medicine Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.