Individual provider Active NPI

Jon M Ishihara, O.D.

  • Optometrist
  • Waipahu, HI
National Provider Identifier
1376691501
Registry record updated Sep 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
273 Issued in HI
Practice address
94-849 Lumiaina Street
Suite 103
Waipahu, HI 96797
Phone
(808) 671-1656
Fax
(808) 671-2020
NPI assigned
Jan 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 273 HI Primary

Addresses

Primary practice location

94-849 Lumiaina Street
Suite 103
Waipahu, HI 96797

Mailing address

94-849 Lumiaina Street
Suite 103
Waipahu, HI 96797
Phone (808) 671-1656

Other identifiers 3

IdentifierTypeStateIssuer
03163502MedicaidHI
55923OtherHIGROUP NUMBER HONOLULU SIT
55928OtherHIGROUP NUMBER WAIPAHU SITE

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
I20031118000538 HI Practitioner - Optometry 7113831876 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

94 -849 Lumiaina St
Unit 103
Waipahu, HI 96797-5677
Phone (808) 671-1656

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
273HIMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
DRS Kuwabara Ishihara Ishimoto & Arakaki Optometrists Inc Optometrist CurrentSince Sep 29, 2018 Accepting new patients
DRS Kuwabara Ishihara Ishimoto & Arakaki Optometrists Inc Optometrist CurrentSince Sep 29, 2018 Accepting new patients

Locations

1441 Kapiolani Blvd
Ste 1520
Honolulu, HI 96814
Phone (808) 973-2015

94-849 Lumiaina St
Unit 103
Waipahu, HI 96797
Phone (808) 671-1656

94-748 Hikimoe St
Ste C
Waipahu, HI 96797
Phone (808) 671-1656

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.

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347321600000",
    "number": "1376691501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94-849 LUMIAINA STREET",
            "address_2": "SUITE 103",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "96797",
            "telephone_number": "808-671-1656",
            "fax_number": "808-671-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94-849 LUMIAINA STREET",
            "address_2": "SUITE 103",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "96797",
            "telephone_number": "808-671-1656",
            "fax_number": "808-671-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISHIHARA",
        "first_name": "JON",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-05",
        "last_updated": "2012-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "HI",
            "license": "273",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03163502",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NUMBER HONOLULU SIT",
            "identifier": "55923",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NUMBER WAIPAHU SITE",
            "identifier": "55928",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waipahu, HI

Sources for this page

Verify at the official NPI Registry.