Active NPI
Keith Tsugio Matsumoto, M.D.
- Pediatrics Physician
- Honolulu, HI
National Provider Identifier
1366858953
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 4464
- Practice address
- 1319 Punahou Street
Suite 9000
Honolulu, HI 96826-1032 - Phone
- (808) 949-0011
- Fax
- (808) 943-2536
- NPI assigned
- Jul 3, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 4464 | HI | Primary |
Addresses
Primary practice location
1319 Punahou Street
Suite 9000
Honolulu, HI 96826-1032
Mailing address
1319 Punahou Street
Suite 900
Honolulu, HI 96826-1032
Phone (808) 949-0011
Other names 1
- Mr. Keith Tsugio Matsumoto
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4464 | HI | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| James K Nakamura MD Inc | Pediatrics | Past | Accepting new patients |
| Keith T Matsumoto MD Inc | Pediatrics | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Pediatrics Physician
- Honolulu, HI
- NPI 1659454635
-
- Pediatrics Physician
- Honolulu, HI
- NPI 1447368147
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404345600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404345600000",
"number": "1366858953",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1319 PUNAHOU STREET",
"address_2": "SUITE 900",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968261032",
"telephone_number": "808-949-0011",
"fax_number": "808-943-2536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1319 PUNAHOU STREET",
"address_2": "SUITE 9000",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968261032",
"telephone_number": "808-949-0011",
"fax_number": "808-943-2536"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATSUMOTO",
"first_name": "KEITH",
"middle_name": "TSUGIO",
"name_prefix": "Mr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-07-03",
"last_updated": "2014-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "HI",
"license": "4464",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KEITH",
"last_name": "MATSUMOTO",
"middle_name": "TSUGIO",
"prefix": "MR.",
"credential": "M.D.",
"code": "2",
"type": "Professional Name"
}
]
}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 Jul 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.