Active NPI
Ronald T Kobayashi, MD
- Surgery Physician
- Tamuning, GU
National Provider Identifier
1104975689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- M001025
- Practice address
- 590 South Marine Corps Drive
Gitc Biulding Ste 211
Tamuning, GU 96913 - Phone
- (671) 649-7588
- Fax
- (671) 646-1088
- NPI assigned
- Jan 10, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | M001025 | GU | Primary |
| Vascular Surgery Physician | 2086S0129X | M001025 | GU |
Addresses
Primary practice location
590 South Marine Corps Drive
Gitc Biulding Ste 211
Tamuning, GU 96913
Mailing address
590 South Marine Corps Drive
Gitc Biulding Ste 211
Tamuning, GU 96913
Phone (671) 649-7588
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GU
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040622000123 | GU | Practitioner - General Surgery | 7911896618 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Other, 1980
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
633 Gov Carlos Camacho Rd
Suite 212
Tamuning, GU 96913-3134
Phone (671) 649-7588
Hospital & facility affiliations
- Guam Memorial Hospital Authority
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 22 |
| Hernia repair - groin (open) | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 17 |
| Melanoma (skin cancer) excision | 1-10 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M001025 | GU | MD | Vascular Surgery Physician |
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 and National Provider Directory roles.
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392681600000",
"number": "1104975689",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "590 SOUTH MARINE CORPS DRIVE",
"address_2": "GITC BIULDING STE 211",
"city": "TAMUNING",
"state": "GU",
"postal_code": "96913",
"telephone_number": "671-649-7588",
"fax_number": "671-646-1088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "590 SOUTH MARINE CORPS DRIVE",
"address_2": "GITC BIULDING STE 211",
"city": "TAMUNING",
"state": "GU",
"postal_code": "96913",
"telephone_number": "671-649-7588",
"fax_number": "671-646-1088"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOBAYASHI",
"first_name": "RONALD",
"middle_name": "T",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-10",
"last_updated": "2014-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "GU",
"license": "M001025",
"primary": true
},
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "GU",
"license": "M001025",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tamuning, GU
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2014; 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.