Organization Active NPI

Mek MD Inc

  • Pulmonary Disease Physician
  • Honolulu, HI
National Provider Identifier
1417062092
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
HI12656 Issued in HI
Legal business name
MEK MD INC
Practice address
929 Koae St
Honolulu, HI 96816-5004
Phone
(808) 734-1130
Fax
(808) 734-4425
NPI assigned
Aug 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

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

Authorized official

Name
Dr. Marc Evan Kruger, MDNPI 1275572026
Title
President / Ceo
Phone
(808) 221-2161

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
Pulmonary Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RP1001X HI12656 HI Primary

Addresses

Primary practice location

929 Koae St
Honolulu, HI 96816-5004

Mailing address

929 Koae St
Honolulu, HI 96816-5004
Phone (808) 221-2161

Other identifiers 2

IdentifierTypeStateIssuer
54750702MedicaidHI
00B0245072OtherHIHMSA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050202000255 HI Part B Supplier - Clinic/Group Practice 7810948320 Receives reassigned benefits from 2 practitioners
Practice locations: Aiea, HI

National Provider Directory

National Provider Directory

Locations

98-1079 Moanalua Rd
Ste 430
Aiea, HI 96701
Phone (808) 484-2000

Practitioners & affiliated clinicians

Practitioners 3

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": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755734400000",
    "number": "1417062092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "929 KOAE ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968165004",
            "telephone_number": "808-221-2161",
            "fax_number": "808-734-4425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 KOAE ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968165004",
            "telephone_number": "808-734-1130",
            "fax_number": "808-734-4425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEK MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A",
        "authorized_official_last_name": "KRUGER",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "EVAN",
        "authorized_official_title_or_position": "PRESIDENT / CEO",
        "authorized_official_telephone_number": "808-221-2161",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "HI",
            "license": "HI12656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54750702",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "00B0245072",
            "state": "HI"
        }
    ],
    "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 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.