NPIMap

Individual provider Active NPI

Marissa Keiko Takase, MD

  • Internal Medicine Physician
  • Honolulu, HI
National Provider Identifier
1336536168
Registry record updated Sep 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD-19622 Issued in HI
Practice address
1356 Lusitana St FL 7
Honolulu, HI 96813-2409
Phone
(808) 586-2890
NPI assigned
Apr 20, 2015
Last updated
Sep 18, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD-19622 HI Primary

Addresses

Primary practice location

1356 Lusitana St FL 7
Honolulu, HI 96813-2409

Mailing address

1356 Lusitana St Ste 510
Honolulu, HI 96813-2409
Phone (808) 586-2890

Other names 1

  • Marissa Keiko Isaki Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180918000994 HI Practitioner - Internal Medicine 3274884069 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Hawaii John a. Burns School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pearl City Medical Associates IncGroup PAC ID 1456332238, 8 clinicians

Practice addresses (Care Compare)

98 -1079 Moanalua Rd
Suite 500
Aiea, HI 96701-4794
Phone (808) 488-0990

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
The Queens Medical Center CurrentSince Jul 18, 2018 Accepting new patients
The Queen's Medical Center Current Accepting new patients
Queen Emma Clinics CurrentSince Jul 18, 2018 Accepting new patients
Pearl City Medical Associates, Inc. Internal Medicine CurrentSince Aug 1, 2019 Accepting new patients
Inteleretina Professional Group LLC Past Accepting new patients

Locations

98-1079 Moanalua Rd
Ste 500
Aiea, HI 96701
Phone (808) 488-0990

1301 Punchbowl St
Honolulu, HI 96813
Phone (808) 538-9011

550 S Beretania St
Ste 404
Honolulu, HI 96813
Phone (808) 691-8897

Organizations & group practices 5

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1429488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537228800000",
    "number": "1336536168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1356 LUSITANA ST STE 510",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132409",
            "telephone_number": "808-586-2890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1356 LUSITANA ST FL 7",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132409",
            "telephone_number": "808-586-2890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAKASE",
        "first_name": "MARISSA",
        "middle_name": "KEIKO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-20",
        "last_updated": "2018-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "MD-19622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISSA",
            "last_name": "ISAKI",
            "middle_name": "KEIKO",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.