Roger Christian Ede, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

103 Issued in HI

Practice address

377 Keahole St
Honolulu, HI 96825-3405

Phone

(808) 396-6311

Fax

(808) 395-2448

NPI assigned

Nov 17, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Vision Care Center of Hawaii LLC

  • Optometrist
  • Waipahu, HI
  • NPI 1790442812
  NPD

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

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568851200000",
    "number": "1407838162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94-050 FARRINGTON HWY",
            "address_2": "STE B1-1",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967971800",
            "telephone_number": "808-677-1544",
            "fax_number": "808-671-3538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "377 KEAHOLE ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968253405",
            "telephone_number": "808-396-6311",
            "fax_number": "808-395-2448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDE",
        "first_name": "ROGER",
        "middle_name": "CHRISTIAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-17",
        "last_updated": "2019-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "HI",
            "license": "103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE SUPPLIER",
            "identifier": "0406020005",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE SUPPLIER",
            "identifier": "0406020001",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE SUPPLIER",
            "identifier": "0406020002",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jazreel Escalante Eclarinal, RN
• Christina Economos, M.D.
• Daryll Joy Edades
• Ralph Vincent Vincent Manuel Edades
• Eddie a. Lim M.D. Inc
• Edgar T. Dela Cruz M.D., Inc.
• Edith L. Pang M.D. Inc.
• Edith Pang MD LLC
• Edith Vajda
• Brenda H Edmonds, PSY.D.

• Optometrist in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Optometrist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.