Active NPI
R. Craig Netzer MD Inc
- Internal Medicine Physician
- Lihue, HI
National Provider Identifier
1316012289
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD11719
- Legal business name
- R. CRAIG NETZER MD INC
- Practice address
- 4473 Pahee St
Ste O
Lihue, HI 96766-2037 - Phone
- (808) 246-2002
- Fax
- (808) 246-2700
- NPI assigned
- Nov 22, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Craig Netzer, MD
- Title
- Medical Doctor
- Phone
- (808) 246-2002
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD11719 | HI | Primary |
Addresses
Primary practice location
4473 Pahee St
Ste O
Lihue, HI 96766-2037
Mailing address
4473 Pahee St
Ste L
Lihue, HI 96766-2037
Phone (808) 632-0200
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 50101602 | Medicaid | HI | |
| HMSA BC HAWAII | Other | HI | 00A0232684 |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in HI
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 12D1036113 | R Craig Netzer MD Inc | Certificate of waiver | Jan 19, 2027 |
National Provider Directory
National Provider DirectoryLocations
4473 Pahee St
Ste 0
Lihue, HI 96766
Phone (808) 246-2002
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Lihue, HI
- NPI 1205831864
-
- Internal Medicine Physician
- Lihue, HI
- NPI 1316996358
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164153600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1294185600000",
"number": "1316012289",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4473 PAHEE ST",
"address_2": "STE L",
"city": "LIHUE",
"state": "HI",
"postal_code": "967662037",
"telephone_number": "808-632-0200",
"fax_number": "808-632-0201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4473 PAHEE ST",
"address_2": "STE O",
"city": "LIHUE",
"state": "HI",
"postal_code": "967662037",
"telephone_number": "808-246-2002",
"fax_number": "808-246-2700"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "R. CRAIG NETZER MD INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-22",
"last_updated": "2011-01-05",
"status": "A",
"authorized_official_last_name": "NETZER",
"authorized_official_first_name": "CRAIG",
"authorized_official_title_or_position": "MEDICAL DOCTOR",
"authorized_official_telephone_number": "808-246-2002",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": "HI",
"license": "MD11719",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "50101602",
"state": "HI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "00A0232684",
"identifier": "HMSA BC HAWAII",
"state": "HI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lihue, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.