Organization Active NPI

Jiro Saegusa MD Inc

  • Pediatrics Physician
  • Honolulu, HI
National Provider Identifier
1407819238
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD2810 Issued in HI
Legal business name
JIRO SAEGUSA MD INC
Practice address
1441 Kapiolani Blvd
Ste 1904
Honolulu, HI 96814-4408
Phone
(808) 946-0990
Fax
(808) 946-4001
NPI assigned
Apr 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Jiro Saegusa, MDNPI 1275710444
Title
President
Phone
(808) 946-0990

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X MD2810 HI Primary

Addresses

Primary practice location

1441 Kapiolani Blvd
Ste 1904
Honolulu, HI 96814-4408

Mailing address

1441 Kapiolani Blvd
Ste 1904
Honolulu, HI 96814-4408
Phone (808) 946-0990

Other identifiers 5

IdentifierTypeStateIssuer
03732202MedicaidHI
0004037774OtherAETNA
00B00411099OtherAIU INS CO
MD281002OtherQUEENS HEALTH CARE PLAN
22249101OtherHMA

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
12D1017101Jiro Saegusa, MD1441 Kapiolani Blvd, #1904, Honolulu, HI 96814Certificate of waiverSep 15, 2027

National Provider Directory

National Provider Directory

Locations

1441 Kapiolani Blvd
Ste 1904
Honolulu, HI 96814
Phone (808) 946-0990

Practitioners & affiliated clinicians

Practitioners 2

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": "1144713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407819238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 KAPIOLANI BLVD",
            "address_2": "STE 1904",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968144408",
            "telephone_number": "808-946-0990",
            "fax_number": "808-946-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 KAPIOLANI BLVD",
            "address_2": "STE 1904",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968144408",
            "telephone_number": "808-946-0990",
            "fax_number": "808-946-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JIRO SAEGUSA MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SAEGUSA",
        "authorized_official_first_name": "JIRO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "808-946-0990",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "HI",
            "license": "MD2810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03732202",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0004037774",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AIU INS CO",
            "identifier": "00B00411099",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUEENS HEALTH CARE PLAN",
            "identifier": "MD281002",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMA",
            "identifier": "22249101",
            "state": null
        }
    ],
    "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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.