Organization Active NPI

Janice Matsunaga, M.D., Inc.

  • Dermatology Physician
  • Honolulu, HI
National Provider Identifier
1275828907
Registry record updated Jun 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
5265 Issued in HI
Legal business name
JANICE MATSUNAGA, M.D., INC.
Practice address
1329 Lusitana Street
Suite 507
Honolulu, HI 96813-2412
Phone
(808) 532-0155
Fax
(808) 532-0160
NPI assigned
Jun 10, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2011

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

Authorized official

Name
Janice Matsunaga, M. D.NPI 1083676795
Title
Owner
Phone
(808) 532-0155

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X 5265 HI Primary

Addresses

Primary practice location

1329 Lusitana Street
Suite 507
Honolulu, HI 96813-2412

Mailing address

1329 Lusitana Street
Suite 507
Honolulu, HI 96813-2412
Phone (808) 532-0155

Other identifiers 1

IdentifierTypeStateIssuer
01882001MedicaidHI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110705000216 HI Part B Supplier - Clinic/Group Practice 8628256195 Receives reassigned benefits from 1 practitioner
Practice locations: Honolulu, HI

National Provider Directory

National Provider Directory

Locations

1329 Lusitana St
Ste 507
Honolulu, HI 96813
Phone (808) 532-0155

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1307664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307664000000",
    "number": "1275828907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1329 LUSITANA STREET",
            "address_2": "SUITE 507",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132412",
            "telephone_number": "808-532-0155",
            "fax_number": "808-532-0160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1329 LUSITANA STREET",
            "address_2": "SUITE 507",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132412",
            "telephone_number": "808-532-0155",
            "fax_number": "808-532-0160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JANICE MATSUNAGA, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-10",
        "last_updated": "2011-06-10",
        "status": "A",
        "authorized_official_last_name": "MATSUNAGA",
        "authorized_official_first_name": "JANICE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-532-0155",
        "authorized_official_credential": "M. D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "HI",
            "license": "5265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01882001",
            "state": "HI"
        }
    ],
    "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 Jun 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.