Active NPI
Joseph R Dicostanzo Jr., MD
- Physical Medicine & Rehabilitation Physician
- Honolulu, HI
National Provider Identifier
1114979507
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- 13514
- Practice address
- 459 Patterson Rd
Honolulu, HI 96819-1522 - Phone
- (800) 214-3106
- NPI assigned
- May 16, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 13514 | HI | Primary |
Addresses
Primary practice location
459 Patterson Rd
Honolulu, HI 96819-1522
Mailing address
459 Patterson Rd
Honolulu, HI 96819-1522
Phone (800) 214-1306
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000267682 | Other | HMSA BILLING NUMBER | |
| 597148-02 | Medicaid | HI |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/interconnect-prodhim/wcf/epic.community.hie/xcpdrespondinggateways | Health Information Exchange (HIE) |
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: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13514 | HI | MD | Physical Medicine & Rehabilitation Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hawaii Permanente Medical Group Inc | Current | Accepting new patients | |
| Jayhawk Healthcare LLC | Occupational Medicine | Past | Accepting new patients |
Locations
1010 Pensacola St
Fl 2
Honolulu, HI 96814
3288 Moanalua Rd
Honolulu, HI 96819
Phone (808) 265-9205
711 Kapiolani Blvd
Honolulu, HI 96813
Phone (808) 432-5312
1010 Pensacola St
Honolulu, HI 96814
Phone (808) 432-2000
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.
-
- Health Maintenance Organization
- Honolulu, HI
- NPI 1710945969
-
- Emergency Medicine Physician
- Lawrence, KS
- NPI 1205889169
Occupational Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734652800000",
"number": "1114979507",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "459 PATTERSON RD",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968191522",
"telephone_number": "800-214-1306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "459 PATTERSON RD",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968191522",
"telephone_number": "800-214-3106"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICOSTANZO",
"first_name": "JOSEPH",
"middle_name": "R",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-16",
"last_updated": "2024-12-20",
"certification_date": "2024-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "HI",
"license": "13514",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HMSA BILLING NUMBER",
"identifier": "0000267682",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "597148-02",
"state": "HI"
}
],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/interconnect-prodhim/wcf/epic.community.hie/xcpdrespondinggateways",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "1010 Pensacola St",
"city": "Honolulu",
"state": "HI",
"country_code": "US",
"postal_code": "968142118",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Honolulu, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.