Pedro Acfalle Manibusan Jr., D.O.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

DOS1269 Issued in HI

Practice address

1 Jarrett White Rd
Tripler Army Medical Center, HI 96859-5001

Phone

(808) 433-5055

NPI assigned

Jan 11, 2008

Last updated

Sep 17, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Specialty

Gastroenterology

Education

Touro Un College of Osteopathic Medicine, Vallejo, 2007

Medicare assignment

May accept Medicare assignment

Group practices

Maui Health System a Kaiser Foundation Hospitals LLCGroup PAC ID 9830476159, 52 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Maui Memorial Medical Center Hospital, Wailuku, HI, CCN 120002
• Kuakini Medical Center Hospital, Honolulu, HI, CCN 120007

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

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

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.

• Maui Health System a Kaiser Foundation Hospitals LLC

  dba Maui Memorial Medical Center

  • General Acute Care Hospital
  • Wailuku, HI
  • NPI 1013379460
  Medicare reassignment Care Compare group NPD
• Manibusan Services Corporation

  • Gastroenterology Physician
  • Honolulu, HI
  • NPI 1770213233
  Medicare reassignment Authorized official
• Hilo Benioff Medical Center

  • General Acute Care Hospital
  • Hilo, HI
  • NPI 1962584060
  Medicare reassignment NPD
• Hilo Benioff Medical Center

  • Anesthesiology Physician
  • Hilo, HI
  • NPI 1235981614
  NPD
• Hilo Benioff Medical Center

  • General Acute Care Hospital
  • Hilo, HI
  • NPI 1780757856
  NPD
• Maui Health System a Kaiser Foundation Hospitals LLC

  • Specialist
  • Wailuku, HI
  • NPI 1669834016
  NPD
• Maui Health System a Kaiser Foundation Hospitals LLC

  dba Lanai Community Hospital Skilled Nursing and Intermediate Care Facilit

  • Nursing Facility/Intermediate Care Facility
  • Lanai, HI
  • NPI 1841645959
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Kuakini Medical Center

  • General Acute Care Hospital
  • Honolulu, HI
  • NPI 1215939335
  Care Compare affiliation
• Maui Health System a Kaiser Foundation Hospitals LLC

  dba Maui Memorial Medical Center

  • General Acute Care Hospital
  • Wailuku, HI
  • NPI 1013379460
  Care Compare affiliation

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

{
    "created_epoch": "1200009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631836800000",
    "number": "1073799722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 JARRETT WHITE RD",
            "city": "TRIPLER ARMY MEDICAL CENTER",
            "state": "HI",
            "postal_code": "968595001",
            "telephone_number": "808-433-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 JARRETT WHITE RD",
            "city": "TRIPLER ARMY MEDICAL CENTER",
            "state": "HI",
            "postal_code": "968595001",
            "telephone_number": "808-433-5055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANIBUSAN",
        "first_name": "PEDRO",
        "middle_name": "ACFALLE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-11",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "DO198300",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "HI",
            "license": "DOS1269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "pedro.a.manibusan.mil@mail.mil",
            "affiliation": "N",
            "endpointDescription": "Official email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1 Jarrett White Rd",
            "city": "Tripler Army Medical Center",
            "state": "HI",
            "country_code": "US",
            "postal_code": "968595001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kelly Judith Mackey, RN
• Asha Mada
• Michael Allan Madsen, DO
• Anthony J Magee Jr., MD
• James D. Maliszewskyj, CRNA
• Victoria Mank, MD
• Adam Mann, DO
• Rosalynn Manophinives, MD
• Jaquelyn Marcinak, PSYD
• Christopher William Marenco, MD

• Gastroenterology Physician in Tripler Army Medical Center, HI
• Providers in Tripler Army Medical Center, HI by specialty
• Gastroenterology Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.