Individual provider Active NPI

Richard Masashi Moriyama Jr., PA-C

  • Physician Assistant
  • Honolulu, HI
National Provider Identifier
1225146897
Registry record updated Aug 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
AMD-177 Issued in HI
Practice address
Tripler Army Medical Center 1 Jarrett White Road
Honolulu, HI 40121-5111
Phone
(808) 433-6661
NPI assigned
Aug 25, 2006
Last updated
Aug 14, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X AMD-177 HI Primary

Addresses

Primary practice location

Tripler Army Medical Center 1 Jarrett White Road
Honolulu, HI 40121-5111

Mailing address

Tripler Army Medical Center 1 Jarrett Road
Honolulu, HI 96859
Phone (808) 655-9053

Other practice location 1

Schofield Barracks Soldier readiness Process
1552 Trimble Road Bldg 555
Wahiawa, HI 96859
Phone (808) 655-9053

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AMD-177HIMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1225146897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "TRIPLER ARMY MEDICAL CENTER 1 JARRETT ROAD",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "96859",
            "telephone_number": "808-655-9053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "TRIPLER ARMY MEDICAL CENTER 1 JARRETT WHITE ROAD",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "401215111",
            "telephone_number": "808-433-6661"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Schofield Barracks Soldier readiness Process",
            "address_2": "1552 Trimble Road Bldg 555",
            "address_purpose": "LOCATION",
            "city": "Wahiawa",
            "state": "HI",
            "postal_code": "96859",
            "country_code": "US",
            "telephone_number": "808-655-9053",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORIYAMA",
        "first_name": "RICHARD",
        "middle_name": "MASASHI",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "HI",
            "license": "AMD-177",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 14, 2023; 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.