Individual provider Active NPI

Bradley Ross Hall, M.D.

  • Anesthesiology Physician
  • Honolulu, HI
National Provider Identifier
1174617195
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Practice address
1329 Lusitana St Ste 604
Honolulu, HI 96813-2431
Phone
(808) 531-1116
NPI assigned
Oct 3, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

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
Anesthesiology Physician 207L00000X HI Primary

Addresses

Primary practice location

1329 Lusitana St Ste 604
Honolulu, HI 96813-2431

Mailing address

4711 Matsonia Dr
Honolulu, HI 96816-4011
Phone (808) 732-1119

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
I20050927001238 HI Practitioner - Anesthesiology 9335174507 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Wayne State University School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1301 Punchbowl St
Honolulu, HI 96813-2402
Phone (808) 691-1000

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Island Medical Consultants, LLC Anesthesiology CurrentSince Jun 1, 2012 Accepting new patients
Bradley R Hall MD Inc Anesthesiology CurrentSince Jun 29, 2023 Accepting new patients

Locations

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

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

1329 Lusitana St
Ste 604
Honolulu, HI 96813
Phone (808) 351-1116

500 Ala Moana Blvd
Ste 1B
Honolulu, HI 96813
Phone (808) 227-6477

1001 Kamokila Blvd
Ste 229
Kapolei, HI 96707

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, 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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174617195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4711 MATSONIA DR",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968164011",
            "telephone_number": "808-732-1119",
            "fax_number": "808-739-1037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1329 LUSITANA ST STE 604",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132431",
            "telephone_number": "808-531-1116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "BRADLEY",
        "middle_name": "ROSS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "HI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.