Individual provider Active NPI

Harold Dan Bertil Nilsson, M.D.

  • Pediatrics Physician
  • Honolulu, HI
National Provider Identifier
1174544878
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD7520 Issued in HI
Practice address
1441 Kapiolani Blvd
Suite 825
Honolulu, HI 96814-4402
Phone
(808) 941-2772
Fax
(808) 947-4150
NPI assigned
Jul 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD7520 HI Primary

Addresses

Primary practice location

1441 Kapiolani Blvd
Suite 825
Honolulu, HI 96814-4402

Mailing address

1441 Kapiolani Blvd
Suite 825
Honolulu, HI 96814-4402
Phone (808) 941-2772

Other identifiers 2

IdentifierTypeStateIssuer
02787301MedicaidHI
C3118-1OtherHIHMSA PPO/HPH

Other names 1

  • Dr. Harald Dan Bertil Nilsson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD7520HIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Harold Nilsson, M.D., LLC Pediatrics Current Accepting new patients

Locations

1441 Kapiolani Blvd
Ste 825
Honolulu, HI 96814
Phone (808) 521-8211

Organizations & group practices 1

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174544878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 KAPIOLANI BLVD",
            "address_2": "SUITE 825",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968144402",
            "telephone_number": "808-941-2772",
            "fax_number": "808-947-4150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 KAPIOLANI BLVD",
            "address_2": "SUITE 825",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968144402",
            "telephone_number": "808-941-2772",
            "fax_number": "808-947-4150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NILSSON",
        "first_name": "HAROLD",
        "middle_name": "DAN BERTIL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "HI",
            "license": "MD7520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02787301",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA PPO/HPH",
            "identifier": "C3118-1",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HARALD",
            "last_name": "NILSSON",
            "middle_name": "DAN BERTIL",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Jul 8, 2007; 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.