Individual provider Active NPI

Brian M. Higa, D.M.D.

  • Dentist
  • Kea'au, HI
National Provider Identifier
1063475796
Registry record updated Apr 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DT2109 Issued in HI
Practice address
16-192 Pilimua St
Keaau, HI 96749
Phone
(808) 930-0418
Fax
(808) 961-5167
NPI assigned
Apr 12, 2006
Last updated
Apr 18, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DT2109 HI Primary

Addresses

Primary practice location

16-192 Pilimua St
Keaau, HI 96749

Mailing address

244 Haili Street
BLDG B
Hilo, HI 96720-2975
Phone (808) 961-4071

Other identifiers 3

IdentifierTypeStateIssuer
2109OtherHIHDS
571176MedicaidHI
0000251041OtherHIHMSA

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160415000163 HI Order and Referring Only - DentistPractitioner - Dentist 5698073294

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DT2109HIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366243200000",
    "number": "1063475796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "244 HAILI STREET",
            "address_2": "BLDG B",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967202975",
            "telephone_number": "808-961-4071",
            "fax_number": "808-961-5167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16-192 PILIMUA ST",
            "city": "KEAAU",
            "state": "HI",
            "postal_code": "96749",
            "telephone_number": "808-930-0418",
            "fax_number": "808-961-5167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIGA",
        "first_name": "BRIAN",
        "middle_name": "M.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-12",
        "last_updated": "2013-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "HI",
            "license": "DT2109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HDS",
            "identifier": "2109",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "571176",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "0000251041",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kea'au, HI

Sources for this page

Verify at the official NPI Registry.