Active NPI
Stephen A. Bangle, MD
- Internal Medicine Physician
- Wailuku, HI
National Provider Identifier
1043304595
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD-9206
- Practice address
- 80 Mahalani St
Wailuku, HI 96793-2531 - Phone
- (808) 243-6000
- NPI assigned
- Oct 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD-9206 | HI | Primary |
Addresses
Primary practice location
80 Mahalani St
Wailuku, HI 96793-2531
Mailing address
80 Mahalani St
Wailuku, HI 96793-2531
Phone (808) 243-6000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A0203594 | Other | HI | HMSA BILLING NUMBER |
| 076119-03 | Medicaid | HI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD-9206 | HI | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191974400000",
"number": "1043304595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "80 MAHALANI ST",
"city": "WAILUKU",
"state": "HI",
"postal_code": "967932531",
"telephone_number": "808-243-6000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "80 MAHALANI ST",
"city": "WAILUKU",
"state": "HI",
"postal_code": "967932531",
"telephone_number": "808-243-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANGLE",
"first_name": "STEPHEN",
"middle_name": "A.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2007-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "HI",
"license": "MD-9206",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HMSA BILLING NUMBER",
"identifier": "00A0203594",
"state": "HI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "076119-03",
"state": "HI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wailuku, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.