Roy M Koga M D Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

MD-2816 Issued in HI

Legal business name

ROY M KOGA M D INC

Practice address

670 Ponahawai St Ste 120
Hilo, HI 96720-2660

Phone

(808) 961-2673

Fax

(808) 961-3051

NPI assigned

Feb 20, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Roy M Koga, M DNPI 1164511309

Title

Owner

Phone

(808) 961-2673

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in HI

Enrollment records 1

Locations

Practitioners 1

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

• Roy Koga, M.D.

  • Family Medicine Physician
  • Hilo, HI
  • NPI 1164511309
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1203465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285286400000",
    "number": "1336318674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 PONAHAWAI ST",
            "address_2": "STE 120",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967202660",
            "telephone_number": "808-961-2673",
            "fax_number": "808-961-3051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 PONAHAWAI ST STE 120",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967202660",
            "telephone_number": "808-961-2673",
            "fax_number": "808-961-3051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROY M KOGA M D INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-20",
        "last_updated": "2010-09-24",
        "status": "A",
        "authorized_official_last_name": "KOGA",
        "authorized_official_first_name": "ROY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-961-2673",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M D"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "HI",
            "license": "MD-2816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "037014-02",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-HMSA",
            "identifier": "0000040741",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Benjamin Isadore Rotwein, DMD
• Melinda Rousse
• Anna M. Rowe, MD
• Duane Arthur Rowe, O.D.
• Robert M. Rowe, MD
• Zachery Lennon Royer, PHARM D.
• Samuel Mark Ruben, M.D.
• Heajung Ruesing, MD
• Greg W Ruhland, MD
• Shauna Ka'Iulani Russell, D.P.T.

• General Practice Physician in Hilo, HI
• Providers in Hilo, HI by specialty
• General Practice Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2010; 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.