Organization Active NPI

Judy T. Okimura, MD LLC

  • Internal Medicine Physician
  • Honolulu, HI
National Provider Identifier
1366810780
Registry record updated Sep 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD12151 Issued in HI
Legal business name
JUDY T. OKIMURA, MD LLC
Practice address
1380 Lusitana St
Suite 404
Honolulu, HI 96813-2449
Phone
(808) 690-9888
Fax
(808) 690-9821
NPI assigned
Sep 2, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2015

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

Authorized official

Name
Dr. Judy T Okimura, MDNPI 1356454433
Title
Owner
Phone
(808) 951-0433

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X MD12151 HI Primary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X MD12151 HI

Addresses

Primary practice location

1380 Lusitana St
Suite 404
Honolulu, HI 96813-2449

Mailing address

1380 Lusitana St
Suite 404
Honolulu, HI 96813-2449
Phone (808) 690-9888

Other identifiers 1

IdentifierTypeStateIssuer
54061801MedicaidHI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151215000499 HI Part B Supplier - Clinic/Group Practice 3577864669 Receives reassigned benefits from 1 practitioner
Practice locations: Honolulu, HI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
12D2016324Judy T Okimura MD LLC1380 Lusitana St Suite 404, Honolulu, HI 96813Certificate of waiverNov 15, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1441152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441152000000",
    "number": "1366810780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 LUSITANA ST",
            "address_2": "SUITE 404",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132449",
            "telephone_number": "808-690-9888",
            "fax_number": "808-690-9821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 LUSITANA ST",
            "address_2": "SUITE 404",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132449",
            "telephone_number": "808-690-9888",
            "fax_number": "808-690-9821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUDY T. OKIMURA, MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-02",
        "last_updated": "2015-09-02",
        "status": "A",
        "authorized_official_last_name": "OKIMURA",
        "authorized_official_first_name": "JUDY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-951-0433",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "MD12151",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "HI",
            "license": "MD12151",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54061801",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.