Individual provider Active NPI

Jon S Jancaterino, MD

  • Emergency Medicine Physician
  • Wailuku, HI
National Provider Identifier
1063402469
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
7648 Issued in HI
Practice address
Maui Memorial Medical Center
221 Mahalani St
Wailuku, HI 96793
Phone
(808) 242-2290
NPI assigned
Oct 26, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 7648 HI Primary

Addresses

Primary practice location

Maui Memorial Medical Center
221 Mahalani St
Wailuku, HI 96793

Mailing address

421 Olohana St
#2903
Honolulu, HI 96815
Phone (508) 741-7626

Other identifiers 1

IdentifierTypeStateIssuer
3086674MedicaidMA

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
I20060503000036 HI Practitioner - Emergency Medicine 2365494697 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Massachusetts Medical School, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lanai Emergency Medical Associates IncGroup PAC ID 9739431354, 8 clinicians

Practice addresses (Care Compare)

628 7TH St
Lanai City, HI 96763-0650
Phone (808) 545-6411

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7648HIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lanai Emergency Medical Associates Inc Emergency Medicine CurrentSince Sep 1, 2018 Accepting new patients
Maui Memorial Emergency Medical Associates Inc Emergency Medicine CurrentSince Jul 7, 2018 Accepting new patients
The Emergency Group, Inc. Emergency Medicine Past Accepting new patients
Umass Memorial Medical Group Inc Emergency Medicine Past Accepting new patients
Wachusett Emergency Physicians, PC Emergency Medicine Past Accepting new patients

Locations

221 Mahalani St
Wailuku, HI 96793
Phone (808) 242-2290

Organizations & group practices 5

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": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1063402469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 OLOHANA ST",
            "address_2": "#2903",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "96815",
            "telephone_number": "508-741-7626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MAUI MEMORIAL MEDICAL CENTER",
            "address_2": "221 MAHALANI ST",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "96793",
            "telephone_number": "808-242-2290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANCATERINO",
        "first_name": "JON",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-26",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "HI",
            "license": "7648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3086674",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wailuku, HI

Sources for this page

Verify at the official NPI Registry.