Individual provider Active NPI

John Stephens Melish, MD

  • Internal Medicine Physician
  • Honolulu, HI
National Provider Identifier
1205868361
Registry record updated Oct 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD3112 Issued in HI
Practice address
1319 Punahou Street
Suite 1040
Honolulu, HI 96826-1028
Phone
(808) 949-2304
Fax
(808) 951-7004
NPI assigned
Jul 7, 2006
Last updated
Oct 25, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2007

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 MD3112 HI Primary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X MD3112 HI

Addresses

Primary practice location

1319 Punahou Street
Suite 1040
Honolulu, HI 96826-1028

Mailing address

1319 Punahou Street
Suite 1040
Honolulu, HI 96826-1028
Phone (808) 949-2304

Other identifiers 1

IdentifierTypeStateIssuer
03869701MedicaidHI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20051209000217 HI Practitioner - Endocrinology 3678594389 Reassigns benefits to 1 organization
Practice locations: Honolulu, HI

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Yale University School of Medicine, 1966
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1319 Punahou St
Suite 1040
Honolulu, HI 96826-1081
Phone (808) 949-2304

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD3112HIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Queens Medical Center CurrentSince Jul 1, 1996 Accepting new patients
The Queen's Medical Center Current Accepting new patients
Queen Emma Clinics CurrentSince Jul 1, 1996 Accepting new patients
Thomas S Kosasa MD Inc PastSince May 2, 2017 Accepting new patients

Locations

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

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193270400000",
    "number": "1205868361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1319 PUNAHOU STREET",
            "address_2": "SUITE 1040",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968261028",
            "telephone_number": "808-949-2304",
            "fax_number": "808-951-7004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1319 PUNAHOU STREET",
            "address_2": "SUITE 1040",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968261028",
            "telephone_number": "808-949-2304",
            "fax_number": "808-951-7004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELISH",
        "first_name": "JOHN",
        "middle_name": "STEPHENS",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "MD3112",
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "HI",
            "license": "MD3112",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03869701",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.