Individual provider Active NPI

Jennifer Michie Teruya, OD

  • Optometrist
  • Honolulu, HI
National Provider Identifier
1306408661
Registry record updated Jul 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD-915 Issued in HI
Practice address
7766 Waikapu Loop
Honolulu, HI 96825-3025
Phone
(808) 225-4272
NPI assigned
Jul 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD-915 HI Primary

Addresses

Primary practice location

7766 Waikapu Loop
Honolulu, HI 96825-3025

Mailing address

7766 Waikapu Loop
Honolulu, HI 96825-3025

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221122002621 HI Practitioner - Optometry 4385012343 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brian M Teruya OD IncGroup PAC ID 1951778125, 2 clinicians

Practice addresses (Care Compare)

3221 Waialae Ave
Suite 340
Honolulu, HI 96816-5831
Phone (808) 734-4343

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Brian M. Teruya, OD and Mark S. Teruya, OD Optometry Optometrist CurrentSince Oct 1, 2022 Accepting new patients
Brian M Teruya OD Inc Optometrist CurrentSince Oct 1, 2022 Accepting new patients

Locations

3221 Waialae Ave
Ste 340
Honolulu, HI 96816
Phone (808) 734-4343

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.

NPI Registry JSON

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

{
    "created_epoch": "1562457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562457600000",
    "number": "1306408661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7766 WAIKAPU LOOP",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968253025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7766 WAIKAPU LOOP",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968253025",
            "telephone_number": "808-225-4272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERUYA",
        "first_name": "JENNIFER",
        "middle_name": "MICHIE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-07",
        "last_updated": "2019-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "HI",
            "license": "OD-915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.