NPIMap

Organization Active NPI

Pacific Eye Surgery Center, Inc.

  • Ophthalmologic Surgery Clinic/Center
  • Honolulu, HI
National Provider Identifier
1134112840
Registry record updated Feb 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmologic Surgery Clinic/CenterTaxonomy code 261QS0132X
License
MD 5296 Issued in HI
Legal business name
PACIFIC EYE SURGERY CENTER, INC.
Practice address
2055 N King St
Suite 100
Honolulu, HI 96819-3479
Phone
(808) 533-7400
Fax
(808) 521-7798
NPI assigned
Aug 26, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2008

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

Authorized official

Name
M. Pierre Pang, M.D.NPI 1487654794
Title
President
Phone
(808) 533-7400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmologic Surgery Clinic/Center 261QS0132X MD 5296 HI Primary

Addresses

Primary practice location

2055 N King St
Suite 100
Honolulu, HI 96819-3479

Mailing address

2055 N King St
Suite 100
Honolulu, HI 96819-3479
Phone (808) 533-7400

Other identifiers 2

IdentifierTypeStateIssuer
02136102MedicaidHI
02136101MedicaidHI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040510001473 HI Part B Supplier - Clinic/Group Practice 1759370182 Receives reassigned benefits from 4 practitioners
Practice locations: Waipahu, HI; Honolulu, HI

National Provider Directory

National Provider Directory

Locations

2226 Liliha St
Ste 305
Honolulu, HI 96817
Phone (808) 533-7400

2228 Liliha St
Ste 102A
Honolulu, HI 96817
Phone (808) 533-7400

94-871 Farrington Hwy
Waipahu, HI 96797
Phone (808) 677-7400

94-873 Farrington Hwy
Waipahu, HI 96797
Phone (808) 677-9741

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203465600000",
    "number": "1134112840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 N KING ST",
            "address_2": "SUITE 100",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968193479",
            "telephone_number": "808-533-7400",
            "fax_number": "808-521-7798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 N KING ST",
            "address_2": "SUITE 100",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968193479",
            "telephone_number": "808-533-7400",
            "fax_number": "808-521-7798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC EYE SURGERY CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-26",
        "last_updated": "2008-02-20",
        "status": "A",
        "authorized_official_last_name": "PANG",
        "authorized_official_first_name": "M. PIERRE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "808-533-7400",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": "HI",
            "license": "MD 5296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02136102",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02136101",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "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 Feb 20, 2008; 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.