Individual provider Active NPI

Frederick Alan Nitta, M.D.

  • Obstetrics & Gynecology Physician
  • Hilo, HI
National Provider Identifier
1023119385
Registry record updated Feb 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD6338 Issued in HI
Practice address
670 Ponahawai St
Suite 200
Hilo, HI 96720-2660
Phone
(808) 961-5922
Fax
(808) 969-1924
NPI assigned
Sep 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD6338 HI Primary

Addresses

Primary practice location

670 Ponahawai St
Suite 200
Hilo, HI 96720-2660

Mailing address

670 Ponahawai St
Suite 200
Hilo, HI 96720-2660
Phone (808) 961-5922

Other identifiers 3

IdentifierTypeStateIssuer
041524-01MedicaidHI
04569-0OtherHIHMSA QUEST
04569-0OtherHIHMSA

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
I20100917000474 HI Practitioner - Obstetrics/GynecologyPractitioner - General Practice 1557251709 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/GynecologyAlso: General Practice
Education
University of Hawaii John a. Burns School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

670 Ponahawai St
Suite 200
Hilo, HI 96720-7830
Phone (808) 961-5922

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD6338HIMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick a. Nitta, M.D. Inc. CurrentSince Jun 1, 2002 Accepting new patients
Hilo Benioff Medical Center Past Accepting new patients

Locations

670 Ponahawai St
Ste 200
Hilo, HI 96720
Phone (808) 222-8302

Interoperability endpoints

  • Direct secure messaging: fnitta21051@hhsc.direct-ci.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202342400000",
    "number": "1023119385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 PONAHAWAI ST",
            "address_2": "SUITE 200",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967202660",
            "telephone_number": "808-961-5922",
            "fax_number": "808-969-1924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 PONAHAWAI ST",
            "address_2": "SUITE 200",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967202660",
            "telephone_number": "808-961-5922",
            "fax_number": "808-969-1924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NITTA",
        "first_name": "FREDERICK",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2008-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "HI",
            "license": "MD6338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "041524-01",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA QUEST",
            "identifier": "04569-0",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "04569-0",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilo, HI

Sources for this page

Verify at the official NPI Registry.