Individual provider Active NPI

Chrystie Kimie Fujimoto, M.D.

  • Obstetrics & Gynecology Physician
  • Honolulu, HI
National Provider Identifier
1144426909
Registry record updated Oct 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
15081 Issued in HI
Practice address
1401 S Beretania St Ste 310
Honolulu, HI 96814-1872
Phone
(808) 524-4055
Fax
(808) 524-4057
NPI assigned
Jun 26, 2007
Last updated
Oct 14, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 15081 HI Primary

Addresses

Primary practice location

1401 S Beretania St Ste 310
Honolulu, HI 96814-1872

Mailing address

1401 S Beretania St Ste 310
Honolulu, HI 96814-1872
Phone (808) 524-4055

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090813000489 HI Practitioner - Obstetrics/Gynecology 8224182068 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Creighton University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Malama Imaging LLCGroup PAC ID 3274780275, 2 clinicians

Practice addresses (Care Compare)

98 -1079 Moanalua Rd
Aiea, HI 96701-4713
Phone (808) 486-6000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15081HIMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Straub Clinic & Hospital CurrentSince May 12, 2014 Accepting new patients
Straub Clinic & Hospital CurrentSince May 12, 2014 Accepting new patients
Malama Imaging LLC CurrentSince May 4, 2012 Accepting new patients
University Clinical Education & Research Associates Past Accepting new patients

Locations

98-1079 Moanalua Rd
Aiea, HI 96701
Phone (808) 485-4301

1301 Punchbowl St
Honolulu, HI 96813
Phone (808) 538-9011

1319 Punahou St
Honolulu, HI 96826
Phone (808) 485-4300

1401 S Beretania St
Ste 310
Honolulu, HI 96814
Phone (808) 524-4055

888 S King St
Honolulu, HI 96813
Phone (808) 522-4000

Networks

  • HI PPO
  • devoted network organization-c89d4c14-e90f-4cf7-83f9-456527a52335

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413244800000",
    "number": "1144426909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 S BERETANIA ST STE 310",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968141872",
            "telephone_number": "808-524-4055",
            "fax_number": "808-524-4057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S BERETANIA ST STE 310",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968141872",
            "telephone_number": "808-524-4055",
            "fax_number": "808-524-4057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUJIMOTO",
        "first_name": "CHRYSTIE",
        "middle_name": "KIMIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-26",
        "last_updated": "2014-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "HI",
            "license": "15081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.