Individual provider Active NPI

Cory T. Miyamoto, M.D.

  • Gastroenterology Physician
  • Honolulu, HI
National Provider Identifier
1063451003
Registry record updated Jul 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD13498 Issued in HI
Practice address
1301 Punchbowl St
Honolulu, HI 96813-2402
Phone
(808) 538-9011
NPI assigned
Jun 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD13498 HI
Gastroenterology Physician 207RG0100X MD13498 HI Primary

Addresses

Primary practice location

1301 Punchbowl St
Honolulu, HI 96813-2402

Mailing address

321 N Kuakini St
Ste 714
Honolulu, HI 96817-2362
Phone (808) 528-3606

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
I20050922001270 HI Practitioner - GastroenterologyPractitioner - Internal Medicine 7012941636 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Albert Einstein College of Medicine of Yeshiva University, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1380 Lusitana St
Suite 508
Honolulu, HI 96813-2441
Phone (808) 599-2500

Hospital & facility affiliations

  • The Queens Medical Center Hospital, Honolulu, HI, CCN 120001
  • Kuakini Medical Center Hospital, Honolulu, HI, CCN 120007

Merit-based Incentive Payment System (MIPS)

Final score
54.36 of 100Reported as individual
Quality
26.43
Improvement activities
40
Cost
45.96

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy318
Upper gastrointestinal (GI) endoscopy for acid reflux182

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD13498HIMDGastroenterology Physician

Networks

  • HI PPO
  • devoted network organization-c89d4c14-e90f-4cf7-83f9-456527a52335

Interoperability endpoints

  • Direct secure messaging: cory.miyamoto@79748840882180.direct.elationemr.com

Organizations & group practices 1

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.

Hospital & facility affiliations 2

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": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563840000000",
    "number": "1063451003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 N KUAKINI ST",
            "address_2": "STE 714",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968172362",
            "telephone_number": "808-528-3606",
            "fax_number": "808-538-7850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 PUNCHBOWL ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132402",
            "telephone_number": "808-538-9011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIYAMOTO",
        "first_name": "CORY",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-05",
        "last_updated": "2019-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "MD13498",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "HI",
            "license": "MD13498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.