Individual provider Active NPI

Joel Ernest Punzal, OD

  • Optometrist
  • Lihue, HI
National Provider Identifier
1063586741
Registry record updated Jan 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD-607 Issued in HI
Practice address
4454 Nuhou St
Lihue, HI 96766-8022
Phone
(808) 278-8383
Fax
(808) 855-2004
NPI assigned
Nov 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 607 HI
Optometrist 152W00000X OD-607 HI Primary

Addresses

Primary practice location

4454 Nuhou St
Lihue, HI 96766-8022

Mailing address

4454 Nuhou St Ste 513
Lihue, HI 96766-8022
Phone (088) 278-8383

Other identifiers 1

IdentifierTypeStateIssuer
547903-01MedicaidHI

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
I20040416000323 HI Practitioner - Optometry 9638164098 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4300 Nuhou St
Lihue, HI 96766-8002
Phone (808) 245-8765

4454 Nuhou St
Suite 513
Lihue, HI 96766-8022
Phone (808) 278-8383

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OD-607HIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Punzal Vision LLC Optometrist CurrentSince May 13, 2012 Accepting new patients

Locations

4454 Nuhou St
Ste 513
Lihue, HI 96766
Phone (808) 278-8383

4300 Nuhou St
Lihue, HI 96766
Phone (808) 241-4002

Networks

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1063586741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4454 NUHOU ST STE 513",
            "city": "LIHUE",
            "state": "HI",
            "postal_code": "967668022",
            "telephone_number": "088-278-8383",
            "fax_number": "808-855-2004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4454 NUHOU ST",
            "city": "LIHUE",
            "state": "HI",
            "postal_code": "967668022",
            "telephone_number": "808-278-8383",
            "fax_number": "808-855-2004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUNZAL",
        "first_name": "JOEL",
        "middle_name": "ERNEST",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "HI",
            "license": "607",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "HI",
            "license": "OD-607",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "547903-01",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lihue, HI

Sources for this page

Verify at the official NPI Registry.