Individual provider Active NPI

Jack J Zhou, MD

  • Internal Medicine Physician
  • Honolulu, HI
National Provider Identifier
1265402168
Registry record updated Jul 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD 9020 Issued in HI
Practice address
100 N Beretania St
Ste 104
Honolulu, HI 96817-4712
Phone
(808) 538-6532
Fax
(808) 521-6445
NPI assigned
Jan 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD 9020 HI Primary

Addresses

Primary practice location

100 N Beretania St
Ste 104
Honolulu, HI 96817-4712

Mailing address

100 N Beretania St
Ste 104
Honolulu, HI 96817-4712
Phone (808) 538-6532

Other identifiers 2

IdentifierTypeStateIssuer
00G0208251OtherHIHMSA
07921007MedicaidHI

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
I20040518000195 HI Practitioner - Internal Medicine 6901796093 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

100 N Beretania St
Suite 104
Honolulu, HI 96817-4768
Phone (808) 538-6532

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD 9020HIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jack Jie Zhou MD Inc. CurrentSince Jun 27, 2017 Accepting new patients
St. Francis Community Health Services PastSince Mar 1, 1997 Accepting new patients

Locations

100 N Beretania St
Ste 104
Honolulu, HI 96817
Phone (808) 538-6532

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 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": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405555200000",
    "number": "1265402168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N BERETANIA ST",
            "address_2": "STE 104",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968174712",
            "telephone_number": "808-538-6532",
            "fax_number": "808-521-6445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N BERETANIA ST",
            "address_2": "STE 104",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968174712",
            "telephone_number": "808-538-6532",
            "fax_number": "808-521-6445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZHOU",
        "first_name": "JACK",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2014-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "MD 9020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "00G0208251",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07921007",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.