Johnny L. Noblezada, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

TUV006877 Issued in NY

Practice address

1010 Pensacola St
Honolulu, HI 96814-2118

Phone

(808) 432-2000

NPI assigned

Apr 8, 2006

Last updated

Jun 2, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in DC

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  dba Kaiser Permanente Annapolis Medical Center

  • Health Maintenance Organization
  • Annapolis, MD
  • NPI 1952461816

  DC, Optometrist

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  dba Kaiser Permanente Capitol Hill Medical Center

  • Health Maintenance Organization
  • Washington, DC
  • NPI 1093016933
  NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  dba Kaiser Permanente Shady Grove Peritoneal Dialysis Facility

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Rockville, MD
  • NPI 1962108753
  NPD
• Empire Vision Center Inc

  dba Davis Vision

  • Optometrist
  • Syracuse, NY
  • NPI 1750358826
  NPD (past)
• Empire Vision Center, Inc

  dba Visionworks

  • Eyewear Supplier
  • Attleboro, MA
  • NPI 1730635582
  NPD (past)

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

{
    "created_epoch": "1144454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1316900715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 PENSACOLA ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968142118",
            "telephone_number": "808-432-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 PENSACOLA ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968142118",
            "telephone_number": "808-432-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOBLEZADA",
        "first_name": "JOHNNY",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-08",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV006877",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "618275-02",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA BILLING NUMBER",
            "identifier": "0000276584",
            "state": "HI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1010 Pensacola St",
            "city": "Honolulu",
            "state": "HI",
            "country_code": "US",
            "postal_code": "968142118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lawrence K. Nitta
• Kylie-Ann Niuelua
• Keiko Niwa, LMFT
• Esther Wairimu Njoroge, APRN
• Colleen Nobles, LCSW
• Klarisse Nobriga
• Wade Koji Nobuhara, D.D.S., M.S.
• Romy T Nochi, APRN
• Erika Rie Noel, MD
• Kristine Noel, PHD, CCC-SLP

• Optometrist in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Optometrist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.