Individual provider Active NPI

Denny L Bales, M.D.

  • Specialist
  • Honolulu, HI
National Provider Identifier
1023016383
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD4933 Issued in HI
Practice address
1380 Lusitana St
Suite 1002
Honolulu, HI 96813-2449
Phone
(808) 521-7402
Fax
(808) 537-2094
NPI assigned
Jul 11, 2005
Reactivated
Mar 24, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD4933 HI Primary

Addresses

Primary practice location

1380 Lusitana St
Suite 1002
Honolulu, HI 96813-2449

Mailing address

1380 Lusitana St
Suite 1002
Honolulu, HI 96813-2449
Phone (808) 521-7402

Other identifiers 3

IdentifierTypeStateIssuer
01582801MedicaidHI
MD4933-02OtherHIMDX-QUEEN'S HEALTHCARE
C017008OtherHIHMSA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20060113000569 HI Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 2264455443

National Provider Directory

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

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023016383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 LUSITANA ST",
            "address_2": "SUITE 1002",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132449",
            "telephone_number": "808-521-7402",
            "fax_number": "808-537-2094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 LUSITANA ST",
            "address_2": "SUITE 1002",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132449",
            "telephone_number": "808-521-7402",
            "fax_number": "808-537-2094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALES",
        "first_name": "DENNY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-11",
        "last_updated": "2007-07-08",
        "deactivation_date": "2006-03-16",
        "reactivation_date": "2006-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "HI",
            "license": "MD4933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01582801",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDX-QUEEN'S HEALTHCARE",
            "identifier": "MD4933-02",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "C017008",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.