Individual provider Active NPI

Ronald T Kobayashi, MD

  • Surgery Physician
  • Tamuning, GU
National Provider Identifier
1104975689
Registry record updated Feb 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
M001025 Issued in GU
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

Updated by the provider on Feb 18, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040622000123 GU Practitioner - General SurgeryPractitioner - Vascular Surgery 7911896618 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Vascular 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 Hospital, Tamuning, GU, CCN 650001

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy22
Hernia repair - groin (open)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux17
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M001025GUMDVascular 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

Verify at the official NPI Registry.