Individual provider Active NPI

Douglas Craig Olsen, M.D.

  • Family Medicine Physician
  • Hilo, HI
National Provider Identifier
1235273616
Registry record updated Sep 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
10618 Issued in HI
Practice address
670 Ponahawai St
Suite 208
Hilo, HI 96720-2660
Phone
(808) 935-2112
Fax
(808) 935-2110
NPI assigned
Feb 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 10618 HI Primary

Addresses

Primary practice location

670 Ponahawai St
Suite 208
Hilo, HI 96720-2660

Mailing address

670 Ponahawai St
Suite 208
Hilo, HI 96720-2660
Phone (808) 935-2112

Other identifiers 1

IdentifierTypeStateIssuer
251602-12MedicaidHI

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
I20110228000860 HI Practitioner - Family Practice 4880582907 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Hawaii John a. Burns School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

670 Ponahawai St
Suite 208
Hilo, HI 96720-7830
Phone (808) 935-2112

Hospital & facility affiliations

  • Bayada Home Health Care Home health agency, Hilo, HI, CCN 127312
  • Dba Hawai'I Care Choices Hospice, Hilo, HI, CCN 121503
  • Hilo Benioff Medical Center Hospital, Hilo, HI, CCN 120005

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hanai Medical Inc Family Medicine CurrentSince Apr 14, 2024 Accepting new patients

Locations

670 Ponahawai St
Ste 208
Hilo, HI 96720
Phone (808) 935-2112

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AJFABD/Endpoint/AJFABD

Organizations & group practices 2

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1171756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442793600000",
    "number": "1235273616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 PONAHAWAI ST",
            "address_2": "SUITE 208",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967202660",
            "telephone_number": "808-935-2112",
            "fax_number": "808-935-2110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 PONAHAWAI ST",
            "address_2": "SUITE 208",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967202660",
            "telephone_number": "808-935-2112",
            "fax_number": "808-935-2110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSEN",
        "first_name": "DOUGLAS",
        "middle_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-18",
        "last_updated": "2015-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "HI",
            "license": "10618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "251602-12",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilo, HI

Sources for this page

Verify at the official NPI Registry.