Ken Matsumoto, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD-9851 Issued in HI

Practice address

1700 Lanakila Ave
Honolulu, HI 96817-2115

Phone

(808) 832-3823

Fax

(808) 832-5850

NPI assigned

Jan 9, 2007

Last updated

Jun 6, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Psychiatry

Education

University of California, Davis School of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

State of Hawaii Department of HealthGroup PAC ID 5395648539, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• State of Hawaii, Department of Health

  • Community/Behavioral Health Agency
  • Honolulu, HI
  • NPI 1306062690
  Medicare reassignment Care Compare group NPD
• State of Hawaii Department of Health

  • General Acute Care Hospital
  • Kapa'a, HI
  • NPI 1568645109
  NPD

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212710400000",
    "number": "1225187222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 LANAKILA AVE",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968172115",
            "telephone_number": "808-832-3823",
            "fax_number": "808-832-5850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 LANAKILA AVE",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968172115",
            "telephone_number": "808-832-3823",
            "fax_number": "808-832-5850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATSUMOTO",
        "first_name": "KEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2008-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "HI",
            "license": "MD-9851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alex Matsumoto, D.M.D.
• Brian Koshiro Matsumoto, DDS
• Erica M.N. Matsumoto
• Jennifer Matsumoto
• Keith Tsugio Matsumoto, M.D.
• Kentaro Matsumoto, D.D.S.
• Kikue Matsumoto, MT
• Michelle Matsumoto
• Nagisa Stacy Matsumoto, DO
• Paul Ken Matsumoto, MPT

• Psychiatry Physician in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Psychiatry Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2008; 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.