Pediatric Professionals, Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

License

MD4255 Issued in HI

Legal business name

PEDIATRIC PROFESSIONALS, INC.

Practice address

1350 S King St Ste 300
Honolulu, HI 96814-2066

Phone

(808) 593-9944

Fax

(808) 593-0565

NPI assigned

Mar 22, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Wallace J Matthews Jr., M.D.NPI 1619078615

Title

President

Phone

(808) 593-9944

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Wallace J Matthews Jr., M.D.

  • Pediatric Pulmonology Physician
  • Honolulu, HI
  • NPI 1619078615
  Authorized official Same address or phone

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194842674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 S KING ST STE 300",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968142066",
            "telephone_number": "808-593-9944",
            "fax_number": "808-593-0565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 S KING ST STE 300",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968142066",
            "telephone_number": "808-593-9944",
            "fax_number": "808-593-0565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC PROFESSIONALS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MATTHEWS",
        "authorized_official_first_name": "WALLACE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "808-593-9944",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "HI",
            "license": "MD4255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert C. Pedersen, M.D.
• Pediatric Group of Honolulu, LLP
• Pediatric Medical Group, LLC
• Pediatric Ophthalmology Associates of Hawaii Inc
• Pediatric Orthotic and Prosthetic Services - Honolulu, LLC
• Pediatrics Associates, Inc.
• Pediatrics Associates, Inc.
• Pedodontic Associates Inc
• Cassidy Pedraza, MS, GC
• Jerelyn Tagap Pedrina-Schiessel, MSN, FNP-BC

• Specialist in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Specialist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.