Individual provider Active NPI

Ken Daiji Tsubata, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Kailua, HI
National Provider Identifier
1346529153
Registry record updated Aug 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO 212 Issued in HI
Practice address
407 Uluniu St
Suite 107
Kailua, HI 96734-2519
Phone
(808) 266-0066
Fax
(808) 263-6004
NPI assigned
Aug 10, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X PO 212 HI Primary

Addresses

Primary practice location

407 Uluniu St
Suite 107
Kailua, HI 96734-2519

Mailing address

407 Uluniu St
Suite 107
Kailua, HI 96734-2519
Phone (808) 266-0066

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
I20140822001668 HI Practitioner - Podiatry 2860610458 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aloha Foot Centers, Inc.Group PAC ID 9436214418, 2 clinicians

Practice addresses (Care Compare)

407 Uluniu St
Kailua, HI 96734-2530
Phone (808) 266-0066

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue84
Removal of skin lesions13
Removal of nail tissue396
Removal or shaving of skin growth164
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO 212HIMDFoot & Ankle Surgery Podiatrist

Organizations & group practices 1

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": "1312934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408665600000",
    "number": "1346529153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 ULUNIU ST",
            "address_2": "SUITE 107",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967342519",
            "telephone_number": "808-266-0066",
            "fax_number": "808-263-6004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 ULUNIU ST",
            "address_2": "SUITE 107",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967342519",
            "telephone_number": "808-266-0066",
            "fax_number": "808-263-6004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSUBATA",
        "first_name": "KEN",
        "middle_name": "DAIJI",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-10",
        "last_updated": "2014-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "HI",
            "license": "PO 212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kailua, HI

Sources for this page

Verify at the official NPI Registry.