Hawaii Premier Dermatology Inc

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

HAWAII PREMIER DERMATOLOGY INC

Practice address

1600 Kapiolani Blvd Ste 508
Honolulu, HI 96814-3804

Phone

(808) 400-6904

NPI assigned

Jan 4, 2024

Last updated

Jul 5, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tagai Musaev, MDNPI 1376072850

Title

President

Phone

(808) 400-6904

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in HI

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tagai Musaev

  • Dermatology Physician
  • Honolulu, HI
  • NPI 1376072850
  Medicare reassignment Care Compare group NPD Authorized official
• Justin Kaleohano Maio, PA-C

  • Medical Physician Assistant
  • Honolulu, HI
  • NPI 1043647381
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1704326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720137600000",
    "number": "1114797842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 KAPIOLANI BLVD STE 508",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968143804",
            "telephone_number": "808-400-6904",
            "fax_number": "808-431-2852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 KAPIOLANI BLVD STE 508",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968143804",
            "telephone_number": "808-400-6904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAWAII PREMIER DERMATOLOGY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-04",
        "last_updated": "2024-07-05",
        "certification_date": "2024-07-05",
        "status": "A",
        "authorized_official_last_name": "MUSAEV",
        "authorized_official_first_name": "TAGAI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "808-400-6904",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Dermatology Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.