Individual provider Active NPI

Ronald D. Moore, M.D.

  • Internal Medicine Physician
  • Honolulu, HI
National Provider Identifier
1073686283
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD-1548 Issued in HI
Practice address
7192 Kalanianaole Hwy
Honolulu, HI 96825-1800
Phone
(808) 396-6321
Fax
(808) 395-7160
NPI assigned
Nov 16, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD-1548 HI Primary

Addresses

Primary practice location

7192 Kalanianaole Hwy
Honolulu, HI 96825-1800

Mailing address

1946 Young St
Suite 360
Honolulu, HI 96826-2150
Phone (808) 973-7320

Other identifiers 2

IdentifierTypeStateIssuer
028467MedicaidHI
1225444OtherHIUHA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD-1548HIMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073686283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1946 YOUNG ST",
            "address_2": "SUITE 360",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968262150",
            "telephone_number": "808-973-7320",
            "fax_number": "808-973-7325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7192 KALANIANAOLE HWY",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968251800",
            "telephone_number": "808-396-6321",
            "fax_number": "808-395-7160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "RONALD",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "MD-1548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "028467",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHA",
            "identifier": "1225444",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.