Individual provider Active NPI

Shayne Mark Castanera, M.D.

  • Internal Medicine Physician
  • Aiea, HI
National Provider Identifier
1053337469
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD6965 Issued in HI
Practice address
98-1079 Moanalua Rd
Aiea, HI 96701-4713
Phone
(808) 486-6000
NPI assigned
Jul 15, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD6965 HI Primary

Addresses

Primary practice location

98-1079 Moanalua Rd
Aiea, HI 96701-4713

Mailing address

PO Box 5008
Kaneohe, HI 96744-9008
Phone (808) 254-4670

Other identifiers 2

IdentifierTypeStateIssuer
07052002MedicaidHI
H0091655OtherHIHMSA PROVIDER NUMBER

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
I20060112000301 HI Practitioner - Internal Medicine 1456318427 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Hawaii John a. Burns School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

98 -1079 Moanalua Rd
Aiea, HI 96701-4713
Phone (808) 254-4670

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD6965HIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shayne Castanera MD Corp Internal Medicine CurrentSince Dec 11, 2014 Accepting new patients
Hawaii Hospital Physicians Inc Internal Medicine CurrentSince Jul 14, 1998 Accepting new patients
Pali Momi Medical Center Past Accepting new patients

Locations

98-1079 Moanalua Rd
Aiea, HI 96701
Phone (808) 485-4301

98-1079 Moanalua Rd
Rm 437
Aiea, HI 96701

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1053337469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5008",
            "city": "KANEOHE",
            "state": "HI",
            "postal_code": "967449008",
            "telephone_number": "808-254-4670",
            "fax_number": "808-254-4670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98-1079 MOANALUA RD",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967014713",
            "telephone_number": "808-486-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTANERA",
        "first_name": "SHAYNE",
        "middle_name": "MARK",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "MD6965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07052002",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA PROVIDER NUMBER",
            "identifier": "H0091655",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiea, HI

Sources for this page

Verify at the official NPI Registry.