Individual provider Active NPI

Matthew S. Dykema, D.O.

  • Family Medicine Physician
  • Hilo, HI
National Provider Identifier
1255566816
Registry record updated Feb 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DOS-1454 Issued in HI
Practice address
1248 Kinoole St
Suite 101
Hilo, HI 96720-4171
Phone
(808) 935-8398
Fax
(808) 934-8151
NPI assigned
May 26, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2019

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 DOS-1454 HI Primary

Addresses

Primary practice location

1248 Kinoole St
Suite 101
Hilo, HI 96720-4171

Mailing address

1248 Kinoole St
Suite 101
Hilo, HI 96720-4171
Phone (808) 935-8398

Other identifiers 1

IdentifierTypeStateIssuer
1255566816MedicaidVA

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
I20130212000261 HI Practitioner - Family Practice 3678749819 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Joyful Living LLCGroup PAC ID 2365727062, 2 clinicians

Practice addresses (Care Compare)

1248 Kinoole St
Suite 101
Hilo, HI 96720-4171
Phone (808) 935-8398

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions41
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DOS-1454HIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Joyful Living, LLC Family Medicine CurrentSince Jan 27, 2017 Accepting new patients

Locations

1248 Kinoole St
Ste 101
Hilo, HI 96720
Phone (808) 935-8398

Interoperability endpoints

  • Direct secure messaging: matthew.dykema@hawaiihie.medicity.net
  • Direct secure messaging: matthew.dykema@1022772787412996.direct.elationemr.com
  • Direct secure messaging: matthewdykema@jlllc.allscriptsdirect.net

Organizations & group practices 1

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.

Hospital & facility affiliations 4

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": "1243296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549584000000",
    "number": "1255566816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1248 KINOOLE ST",
            "address_2": "SUITE 101",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967204171",
            "telephone_number": "808-935-8398",
            "fax_number": "808-934-8151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1248 KINOOLE ST",
            "address_2": "SUITE 101",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967204171",
            "telephone_number": "808-935-8398",
            "fax_number": "808-934-8151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYKEMA",
        "first_name": "MATTHEW",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-26",
        "last_updated": "2019-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "HI",
            "license": "DOS-1454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255566816",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilo, HI

Sources for this page

Verify at the official NPI Registry.