NPIMap

Organization Active NPI

Gerald N. Matsuyama, O.D., LLC

  • Optometrist
  • Honolulu, HI
National Provider Identifier
1154443166
Registry record updated Apr 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
189 Issued in HI
Legal business name
GERALD N. MATSUYAMA, O.D., LLC
Practice address
1109 12TH Ave Ste 103
Honolulu, HI 96816-3714
Phone
(808) 734-1988
NPI assigned
Apr 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2009

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

Authorized official

Name
Gerald N. Matsuyama, O.D.NPI 1942389879
Title
President
Phone
(808) 734-1988

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 189 HI Primary

Addresses

Primary practice location

1109 12TH Ave Ste 103
Honolulu, HI 96816-3714

Mailing address

1109 12TH Ave Ste 103
Honolulu, HI 96816-3714

Other identifiers 1

IdentifierTypeStateIssuer
01409062MedicaidHI

National Provider Directory

National Provider Directory

Locations

1109 12th Ave
Ste 103
Honolulu, HI 96816
Phone (808) 734-1988

Practitioners & affiliated clinicians

Practitioners 2

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": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240876800000",
    "number": "1154443166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 12TH AVE STE 103",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968163714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 12TH AVE STE 103",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968163714",
            "telephone_number": "808-734-1988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERALD N. MATSUYAMA, O.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2009-04-28",
        "status": "A",
        "authorized_official_last_name": "MATSUYAMA",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "808-734-1988",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "HI",
            "license": "189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01409062",
            "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 Apr 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.