Individual provider Active NPI

Roui Lorenzo Canicula De Castro, M.D.

  • Internal Medicine Physician
  • Ewa Beach, HI
National Provider Identifier
1346777059
Registry record updated Aug 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD-21134 Issued in HI
Practice address
91-6390 Kapolei Pkwy Ste 200
Ewa Beach, HI 96706
Phone
(808) 691-8200
NPI assigned
May 12, 2017
Last updated
Aug 4, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2020

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-21134 HI Primary

Addresses

Primary practice location

91-6390 Kapolei Pkwy Ste 200
Ewa Beach, HI 96706

Mailing address

91-6390 Kapolei Pkwy Ste 200
Ewa Beach, HI 96706
Phone (808) 691-8200

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200803001543 HI Practitioner - Internal Medicine 2365867702 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Primary Care Physician Enterprise LLCGroup PAC ID 0244661338, 12 clinicians

Practice addresses (Care Compare)

91 -6390 Kapolei Pkwy
Suite 200
Ewa Beach, HI 96706-6380
Phone (808) 691-8200

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care Physician Enterprise LLC CurrentSince Aug 24, 2020 Accepting new patients
The Queens Medical Center CurrentSince Aug 24, 2020 Accepting new patients
The Queen's Medical Center CurrentSince Aug 24, 2020 Accepting new patients

Locations

91-6390 Kapolei Pkwy
Ste 200
Ewa Beach, HI 96706
Phone (612) 802-2986

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

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

Interoperability endpoints

  • Direct secure messaging: roui.decastro@hawaiihie.medicity.net

Organizations & group practices 3

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 5

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": "1494547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596499200000",
    "number": "1346777059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91-6390 KAPOLEI PKWY STE 200",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "96706",
            "telephone_number": "808-691-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91-6390 KAPOLEI PKWY STE 200",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "96706",
            "telephone_number": "808-691-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE CASTRO",
        "first_name": "ROUI LORENZO",
        "middle_name": "CANICULA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-12",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "MD-21134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ewa Beach, HI

Sources for this page

Verify at the official NPI Registry.