NPIMap

Individual provider Active NPI

Greggory Scott Shubert, M.D

  • Emergency Medicine Physician
  • Kailua, HI
National Provider Identifier
1114930906
Registry record updated Jul 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
S1918 Issued in TX
Practice address
640 Ulukahiki St
Kailua, HI 96734-4454
Phone
(808) 263-5500
NPI assigned
Aug 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A54609 CA
Emergency Medicine Physician 207P00000X S1918 TX Primary
Emergency Medicine Physician 207P00000X 16430 HI

Addresses

Primary practice location

640 Ulukahiki St
Kailua, HI 96734-4454

Mailing address

407 Uluniu St
Ste 411
Kailua, HI 96734-2519
Phone (808) 261-3326

Other identifiers 1

IdentifierTypeStateIssuer
00A546090MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
54609CAMDPharmacist
A54609CAMDEmergency Medicine Physician
16430HIMDEmergency Medicine Physician
S1918TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Grace Emergency Room, LLC Past Accepting new patients
Hawaii Emergency Physicians Associated Inc Emergency Medicine Past Accepting new patients
Singleton Associates PA Past Accepting new patients
Midpacific Hospitalists LLC Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562889600000",
    "number": "1114930906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 ULUNIU ST",
            "address_2": "STE 411",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967342519",
            "telephone_number": "808-261-3326",
            "fax_number": "808-261-3092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 ULUKAHIKI ST",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967344454",
            "telephone_number": "808-263-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUBERT",
        "first_name": "GREGGORY",
        "middle_name": "SCOTT",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2019-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A54609",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "S1918",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "HI",
            "license": "16430",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A546090",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kailua, HI

Sources for this page

Verify at the official NPI Registry.