Individual provider Active NPI

Erick M Itoman, M.D.

  • Internal Medicine Physician
  • Honolulu, HI
National Provider Identifier
1407056187
Registry record updated Feb 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4589 Issued in HI
Practice address
2845 Oahu Ave
Honolulu, HI 96822-1771
Phone
(808) 542-3057
NPI assigned
Jul 20, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X MT189861 PA
Internal Medicine Physician 207R00000X 4589 HI Primary

Addresses

Primary practice location

2845 Oahu Ave
Honolulu, HI 96822-1771

Mailing address

95-1060 Aoakua St
Mililani, HI 96789-4812

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
I20090916000409 HI Practitioner - Critical Care (Intensivists) 4284780297 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)
Education
University of Hawaii John a. Burns School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Queens University Medical GroupGroup PAC ID 2466831557, 614 clinicians

Practice addresses (Care Compare)

1301 Punchbowl St
Honolulu, HI 96813-2499

1380 Lusitana St
Honolulu, HI 96813-2448

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.05 of 100Reported as apm
Quality
89.81
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4589HIMDInternal Medicine Physician
MT189861PAMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Queens University Medical Group CurrentSince Apr 22, 2022 Accepting new patients
The Queen'S Medical Center Past Accepting new patients

Locations

98-1079 Moanalua Rd
Aiea, HI 96701
Phone (808) 485-4301

1319 Punahou St
Honolulu, HI 96826
Phone (808) 485-4300

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

347 N Kuakini St
Honolulu, HI 96817
Phone (808) 536-2236

1380 Lusitana St
Ste 913
Honolulu, HI 96813
Phone (808) 691-8521

1329 Lusitana St
Ste 107
Honolulu, HI 96813
Phone (808) 691-5201

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.

Hospital & facility affiliations 1

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": "1184889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582675200000",
    "number": "1407056187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95-1060 AOAKUA ST",
            "city": "MILILANI",
            "state": "HI",
            "postal_code": "967894812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2845 OAHU AVE",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968221771",
            "telephone_number": "808-542-3057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ITOMAN",
        "first_name": "ERICK",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-20",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "PA",
            "license": "MT189861",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "4589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.