Individual provider Active NPI

Yuri Imanishi, M.D.

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Honolulu, HI
National Provider Identifier
1184760712
Registry record updated May 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
License
MD-7317 Issued in HI
Practice address
550 S Beretania St Ste 601
Honolulu, HI 96813-2423
Phone
(808) 691-8877
Fax
(808) 691-8875
NPI assigned
Jan 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD-7317 HI
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X MD-7317 HI Primary

Addresses

Primary practice location

550 S Beretania St Ste 601
Honolulu, HI 96813-2423

Mailing address

550 S Beretania St Ste 601
Honolulu, HI 96813-2423
Phone (808) 691-8877

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040420001155 HI Practitioner - Internal MedicinePractitioner - Hospice/Palliative Care 1254326945 Reassigns benefits to 2 organizations
I20150210002454 OR Practitioner - Internal Medicine 1254326945 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD-7317HIMDHospice and Palliative Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Queen's Medical Center CurrentSince Jul 15, 2019 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Internal Medicine Current Accepting new patients
The Queens Medical Center CurrentSince Jul 15, 2019 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Dec 26, 2014 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Internal Medicine CurrentSince Dec 26, 2014 Accepting new patients
Queens University Medical Group CurrentSince Jul 1, 2022 Accepting new patients
St.Uke's - West Care Medical Associates Internal Medicine Past Accepting new patients
Berkshire Faculty Services Inc PastSince Aug 1, 2005 Accepting new patients

Locations

550 S Beretania St
Ste 404
Honolulu, HI 96813
Phone (808) 691-8897

1380 Lusitana St
Ste 913
Honolulu, HI 96813
Phone (808) 691-8521

550 S Beretania St
Ste 601
Honolulu, HI 96813
Phone (808) 691-8877

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

3288 Moanalua Rd
Honolulu, HI 96819
Phone (808) 265-9205

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

2701 NW Vaughn St
Ofc
Portland, OR 97210
Phone (503) 499-5200

2701 NW Vaughn St
Ste 160
Portland, OR 97210
Phone (503) 499-5200

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

Organizations & group practices 8

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": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590624000000",
    "number": "1184760712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 S BERETANIA ST STE 601",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132423",
            "telephone_number": "808-691-8877",
            "fax_number": "808-691-8875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 S BERETANIA ST STE 601",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132423",
            "telephone_number": "808-691-8877",
            "fax_number": "808-691-8875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMANISHI",
        "first_name": "YURI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2020-05-28",
        "certification_date": "2020-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "MD-7317",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "HI",
            "license": "MD-7317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.