Individual provider Active NPI

Stephen M Holmes, MD

  • Diagnostic Radiology Physician
  • Honolulu, HI
National Provider Identifier
1174576953
Registry record updated Apr 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD-4204 Issued in HI
Practice address
1401 S Beretania St
Suite 107
Honolulu, HI 96814-1870
Phone
(808) 591-1504
Fax
(808) 591-1506
NPI assigned
May 19, 2006
Last updated
Apr 1, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD-4204 HI Primary

Addresses

Primary practice location

1401 S Beretania St
Suite 107
Honolulu, HI 96814-1870

Mailing address

PO Box 1300
Dept 60281
Honolulu, HI 96807-1300
Phone (808) 591-1504

Other identifiers 3

IdentifierTypeStateIssuer
003882MedicaidHI
MD4204-02OtherHIMDX HAWAII
XPY187074OtherCAMEDI-CAL

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
I20051014000375 HI Practitioner - Diagnostic RadiologyPractitioner - Radiation OncologyPractitioner - Other (Physician) 7810950599 Practice locations: Honolulu, HI

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Honolulu Imaging Center, LLC Diagnostic Radiology CurrentSince Jun 1, 2024 Accepting new patients
Insight Eeg LLC CurrentSince Aug 19, 2022 Accepting new patients
Radiology Associates, Inc Diagnostic Radiology Past Accepting new patients
Accuimaging Kapahulu, LLC Diagnostic Radiology Past Accepting new patients
Accuimaging Pearlridge, LLC Diagnostic Radiology Past Accepting new patients

Locations

1010 S King St
Ste 109
Honolulu, HI 96814
Phone (808) 593-8080

1401 S Beretania St
Ste 107
Honolulu, HI 96814
Phone (808) 591-1504

Interoperability endpoints

  • Direct secure messaging: haii.oahu@direct.ramsoft.com
  • Direct secure messaging: stephen.holmes@hawaiihie.medicity.net

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396310400000",
    "number": "1174576953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1300",
            "address_2": "DEPT 60281",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968071300",
            "telephone_number": "808-591-1504",
            "fax_number": "808-591-1506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S BERETANIA ST",
            "address_2": "SUITE 107",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968141870",
            "telephone_number": "808-591-1504",
            "fax_number": "808-591-1506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "STEPHEN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2014-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "HI",
            "license": "MD-4204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003882",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDX HAWAII",
            "identifier": "MD4204-02",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "XPY187074",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.