Individual provider Active NPI

Ramin Altaha, MD

  • Hematology & Oncology Physician
  • Wailuku, HI
National Provider Identifier
1083649982
Registry record updated Dec 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
MD-16120 Issued in HI
Practice address
24 North Church Street
Suite 308
Wailuku, HI 96793
Phone
(808) 242-1110
Fax
(855) 839-9759
NPI assigned
Jul 11, 2006
Last updated
Dec 14, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X MD-16120 HI Primary

Addresses

Primary practice location

24 North Church Street
Suite 308
Wailuku, HI 96793

Mailing address

24 North Church Street
Suite 308
Wailuku, HI 96793
Phone (808) 242-1110

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
I20110811000566 HI Practitioner - Hematology/Oncology 0749266815 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

24 N Church St
Suite 308
Wailuku, HI 96793-1608
Phone (808) 242-1110

Merit-based Incentive Payment System (MIPS)

Final score
30 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-16120HIMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maui Cancer Clinic, Inc. CurrentSince Oct 17, 2014 Accepting new patients
Pacific Cancer Institute LLC Past Accepting new patients

Locations

227 Mahalani St
Wailuku, HI 96793
Phone (808) 242-2600

24 N Church St
Ste 308
Wailuku, HI 96793
Phone (808) 242-1110

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AEJICA/Endpoint/AEJICA

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450051200000",
    "number": "1083649982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 NORTH CHURCH STREET",
            "address_2": "SUITE 308",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "96793",
            "telephone_number": "808-242-1110",
            "fax_number": "855-839-9759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 NORTH CHURCH STREET",
            "address_2": "SUITE 308",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "96793",
            "telephone_number": "808-242-1110",
            "fax_number": "855-839-9759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTAHA",
        "first_name": "RAMIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2015-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "HI",
            "license": "MD-16120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wailuku, HI

Sources for this page

Verify at the official NPI Registry.