Individual provider Active NPI

Joan M. Maeshiro, APRN

  • Gerontology Nurse Practitioner
  • Honolulu, HI
National Provider Identifier
1053486035
Registry record updated Nov 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN955 Issued in HI
Practice address
550 S Beretania St
601
Honolulu, HI 96813-2414
Phone
(808) 691-8877
Fax
(808) 691-8875
NPI assigned
Nov 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X APRN955 HI Primary

Addresses

Primary practice location

550 S Beretania St
601
Honolulu, HI 96813-2414

Mailing address

PO Box 29640
Honolulu, HI 96820-2040

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070115000345 HI Practitioner - Nurse Practitioner 7012917107 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN955HIMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Queen'S Medical Center CurrentSince Jan 1, 2007 Accepting new patients
The Queens Medical Center CurrentSince Jan 1, 2007 Accepting new patients
Queens University Medical Group CurrentSince Apr 22, 2022 Accepting new patients

Locations

550 S Beretania St
Ste 404
Honolulu, HI 96813
Phone (808) 691-8897

1380 Lusitana St
Ste 913
Honolulu, HI 96813
Phone (808) 691-8521

550 S Beretania St
Ste 601
Honolulu, HI 96813
Phone (808) 691-8877

1301 Punchbowl St
Honolulu, HI 96813
Phone (808) 538-9011

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479254400000",
    "number": "1053486035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 29640",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968202040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 S BERETANIA ST",
            "address_2": "601",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132414",
            "telephone_number": "808-691-8877",
            "fax_number": "808-691-8875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAESHIRO",
        "first_name": "JOAN",
        "middle_name": "M.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-22",
        "last_updated": "2016-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "HI",
            "license": "APRN955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.