Charles Thomas Mauro IV, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MD12734 Issued in HI

Practice address

868 Ululani St
Suite 103
Hilo, HI 96720-3913

Phone

(808) 961-3427

NPI assigned

Jul 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Dermatology

Education

Medical University of South Carolina College of Medicine, 2000

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: charles.mauro@hawaiihie.medicity.net
• FHIR API: https://fhir4.healow.com/fhir/r4/EFJBAA

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.

• Knott Street Dermatology PC

  • Specialist
  • Portland, OR
  • NPI 1891741864
  Medicare reassignment NPD

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1205840469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "868 ULULANI ST",
            "address_2": "SUITE 103",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967203913",
            "telephone_number": "808-961-3427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "868 ULULANI ST",
            "address_2": "SUITE 103",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967203913",
            "telephone_number": "808-961-3427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAURO",
        "first_name": "CHARLES",
        "middle_name": "THOMAS",
        "name_suffix": "IV",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "HI",
            "license": "MD12734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA NUMBER",
            "identifier": "12D1029385",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sonya Matsuura
• Joseph Mattos
• Mauna Family Dental
• Mauna Kea Medical Services
• Ruth Ramos Mauricio, M.S. P.T.
• Benjamin Aron Mayer
• Chansen McAllister
• Patricia McCarver
• Allison Kiku McClintock, M.A./C.C.C.-S.P.
• Elizabeth McCloud, PSYD

• Dermatology Physician in Hilo, HI
• Providers in Hilo, HI by specialty
• Dermatology Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.