NPIMap

Individual provider Active NPI

Kiyotaka Albert Yazawa, M.D.

  • Geriatric Medicine (Family Medicine) Physician
  • Honolulu, HI
National Provider Identifier
1184694192
Registry record updated Jan 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
MD-11070 Issued in HI
Practice address
1027 Hala Dr
Maluhia
Honolulu, HI 96817
Phone
(808) 832-6129
Fax
(808) 832-1932
NPI assigned
Jan 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X MD-11070 HI Primary

Addresses

Primary practice location

1027 Hala Dr
Maluhia
Honolulu, HI 96817

Mailing address

1508B Pualele PL
Honolulu, HI 96816-3326
Phone (808) 737-8212

Other identifiers 2

IdentifierTypeStateIssuer
00B0228664OtherHIBLUE CROSS/ BLUE SHIELD
00067495MedicaidHI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050506000616 HI Practitioner - Geriatric MedicinePractitioner - Family Practice 7810937034 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Geriatric MedicineAlso: Family Practice
Education
University of Hawaii John a. Burns School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Straub Clinic and HospitalGroup PAC ID 6305759754, 420 clinicians

Practice addresses (Care Compare)

888 S King St
Honolulu, HI 96813-3097
Phone (808) 522-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.72 of 100Reported as group
Quality
67.55
Promoting interoperability
100
Improvement activities
40
Cost
78.18

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Straub Clinic & Hospital CurrentSince Jan 30, 2013 Accepting new patients
Straub Clinic & Hospital CurrentSince Jan 30, 2013 Accepting new patients
Liliha Kupuna SNF, LLC. Past Accepting new patients
Hale Nani Rehab & Nursing Center LLC Past Accepting new patients

Locations

888 S King St
Honolulu, HI 96813
Phone (808) 522-4000

1900 Bachelot St
Honolulu, HI 96817
Phone (808) 531-5302

Networks

  • HI PPO
  • devoted network organization-c89d4c14-e90f-4cf7-83f9-456527a52335

Interoperability endpoints

  • Direct secure messaging: al.yazawa.1@19917.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
The Care Center of HonoluluHonolulu, HI, CCN 125019 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Mar 1, 2020
Mar 1, 2020
Islands Skilled Nursing and Rehabilitation, LLCHonolulu, HI, CCN 125067 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Sep 1, 2019
Sep 1, 2019
Hale Ola Kino by ArcadiaHonolulu, HI, CCN 125069 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Nov 1, 2022
Feb 27, 2025

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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.

Hospital & facility affiliations 9

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": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358985600000",
    "number": "1184694192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1508B PUALELE PL",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968163326",
            "telephone_number": "808-737-8212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1027 HALA DR",
            "address_2": "MALUHIA",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "96817",
            "telephone_number": "808-832-6129",
            "fax_number": "808-832-1932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAZAWA",
        "first_name": "KIYOTAKA",
        "middle_name": "ALBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2013-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "HI",
            "license": "MD-11070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/ BLUE SHIELD",
            "identifier": "00B0228664",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00067495",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.