Individual provider Active NPI

Jason Matthew Unold, DO

  • Emergency Medicine Physician
  • Honolulu, HI
National Provider Identifier
1164086880
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
DOS-2254 Issued in HI
Practice address
1301 Punchbowl St
Honolulu, HI 96813-2402
Phone
(808) 691-1000
NPI assigned
Apr 29, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X DOS-2254 HI Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1301 Punchbowl St
Honolulu, HI 96813-2402

Mailing address

770 Kapiolani Blvd Ste 705
Honolulu, HI 96813-5241

Other practice location 1

4201 Saint Antoine St
Detroit, MI 48201-2153
Phone (313) 993-2530

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
I20220822002580 HI Practitioner - Emergency Medicine 4385977230 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Michigan State University College of Osteopathic Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Emergency Group, Inc.Group PAC ID 1355244542, 49 clinicians

Practice addresses (Care Compare)

1301 Punchbowl St
Honolulu, HI 96813-2402
Phone (808) 597-8778

Hospital & facility affiliations

  • The Queens Medical Center Hospital, Honolulu, HI, CCN 120001

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DOS-2254HIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Emergency Group, Inc. Emergency Medicine CurrentSince Jul 1, 2022 Accepting new patients
First Choice Medical Group PLLC PastSince Nov 1, 2021 Accepting new patients

Locations

91-2141 Fort Weaver Rd
Ewa Beach, HI 96706
Phone (808) 678-7000

770 Kapiolani Blvd
Ste 705
Honolulu, HI 96813
Phone (808) 597-8778

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

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20203/brand/1/csg/1/fhir/r4

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.

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": "1556496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1164086880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 KAPIOLANI BLVD STE 705",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968135241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 PUNCHBOWL ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132402",
            "telephone_number": "808-691-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4201 Saint Antoine St",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482012153",
            "country_code": "US",
            "telephone_number": "313-993-2530",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UNOLD",
        "first_name": "JASON",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-29",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "HI",
            "license": "DOS-2254",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.