Individual provider Active NPI

Peter Rudlowski, M.D.

  • Specialist
  • Honolulu, HI
National Provider Identifier
1194809442
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD 11312 Issued in HI
Practice address
444 Hobron LN Ste 315
Honolulu, HI 96815-1291
Phone
(808) 947-2224
NPI assigned
Oct 24, 2006
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
Specialist 174400000X MD 11312 HI Primary

Addresses

Primary practice location

444 Hobron LN Ste 315
Honolulu, HI 96815-1291

Mailing address

444 Hobron Lane, Suite 315
Honolulu, HI 96815
Phone (808) 947-2224

Other identifiers 1

IdentifierTypeStateIssuer
50129807MedicaidHI

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD 11312HIMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Kalihi Palama Health Center Past Accepting new patients
Wihc, LLC PastSince Sep 1, 2010 Accepting new patients
Lokahi Behavioral Health, Inc. Past Accepting new patients
Aaron Kaplan, PH.D., Inc. Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194809442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 HOBRON LANE, SUITE 315",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "96815",
            "telephone_number": "808-947-2224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 HOBRON LN STE 315",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968151291",
            "telephone_number": "808-947-2224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDLOWSKI",
        "first_name": "PETER",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "HI",
            "license": "MD 11312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "50129807",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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.