Individual provider Active NPI

Mathew K Kaneshiro, LMFT

  • Marriage & Family Therapist
  • North Port, FL
National Provider Identifier
1144468901
Registry record updated Jan 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
208 Issued in HI
Practice address
2403 Honey LN
North Port, FL 34286-2407
Phone
(808) 276-2758
NPI assigned
Jan 31, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 208 HI Primary

Addresses

Primary practice location

2403 Honey LN
North Port, FL 34286-2407

Mailing address

PO Box 8164
North Port, FL 34290-8164
Phone (808) 276-2758

Other identifiers 1

IdentifierTypeStateIssuer
1144468901MedicaidHI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, HI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240216002584 FL Practitioner - Marriage and Family Therapist 7911341045 Reassigns benefits to 1 organization
I20240830002923 HI Practitioner - Marriage and Family Therapist 7911341045 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
208HIMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Marriage & Family Therapist CurrentSince Jan 15, 2024 Accepting new patients
Teladoc Health Medical Group, P.a. Marriage & Family Therapist Current Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

500 Ala Moana Blvd
Ste 7400
Honolulu, HI 96813
Phone (617) 823-6490

Networks

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

Interoperability endpoints

  • Direct secure messaging: mathewkaneshiro@tdh.allscriptsdirect.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1233360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1144468901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8164",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "342908164",
            "telephone_number": "808-276-2758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2403 HONEY LN",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "342862407",
            "telephone_number": "808-276-2758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANESHIRO",
        "first_name": "MATHEW",
        "middle_name": "K",
        "name_prefix": "Mr.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-31",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "HI",
            "license": "208",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144468901",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Port, FL

Sources for this page

Verify at the official NPI Registry.