Active NPI
Matthew Tanaid, RPH
- Pharmacist
- Ewa Beach, HI
National Provider Identifier
1124693296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH-4132
- Practice address
- 91-1081 Keaunui Dr
Ewa Beach, HI 96706-6351 - Phone
- (808) 683-1166
- NPI assigned
- May 21, 2021
- Last updated
- May 21, 2021
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH-4132 | HI | Primary |
Addresses
Primary practice location
91-1081 Keaunui Dr
Ewa Beach, HI 96706-6351
Mailing address
91-1081 Keaunui Dr
Ewa Beach, HI 96706-6351
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH-4132 | HI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
91-1081 Keaunui Dr
Ewa Beach, HI 96706
Phone (808) 683-1166
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621555200000",
"number": "1124693296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "91-1081 KEAUNUI DR",
"city": "EWA BEACH",
"state": "HI",
"postal_code": "967066351"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "91-1081 KEAUNUI DR",
"city": "EWA BEACH",
"state": "HI",
"postal_code": "967066351",
"telephone_number": "808-683-1166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TANAID",
"first_name": "MATTHEW",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-05-21",
"last_updated": "2021-05-21",
"certification_date": "2021-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "HI",
"license": "PH-4132",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ewa Beach, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.