Organization Active NPI

D. Gary Lattimer, M.D., Inc

  • Urology Physician
  • Honolulu, HI
National Provider Identifier
1427368414
Registry record updated Oct 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD7092 Issued in HI
Legal business name
D. GARY LATTIMER, M.D., INC
Practice address
1329 Lusitana St
Suite 708
Honolulu, HI 96813-2429
Phone
(808) 537-5445
Fax
(808) 537-1813
NPI assigned
Oct 8, 2010
Last updated
Oct 8, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2010

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

Authorized official

Name
Ms. Ina C Costa
Title
Practice Manager
Phone
(808) 537-5445

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X MD7092 HI Primary

Addresses

Primary practice location

1329 Lusitana St
Suite 708
Honolulu, HI 96813-2429

Mailing address

1329 Lusitana St
Suite 708
Honolulu, HI 96813-2429
Phone (808) 537-5445

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130325000285 HI Part B Supplier - Clinic/Group Practice 2961647839 Receives reassigned benefits from 1 practitioner
Practice locations: Honolulu, HI

National Provider Directory

National Provider Directory

Locations

1329 Lusitana St
Ste 708
Honolulu, HI 96813
Phone (808) 537-5445

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1286496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286496000000",
    "number": "1427368414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1329 LUSITANA ST",
            "address_2": "SUITE 708",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132429",
            "telephone_number": "808-537-5445",
            "fax_number": "808-537-1813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1329 LUSITANA ST",
            "address_2": "SUITE 708",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132429",
            "telephone_number": "808-537-5445",
            "fax_number": "808-537-1813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D. GARY LATTIMER, M.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-08",
        "last_updated": "2010-10-08",
        "status": "A",
        "authorized_official_last_name": "COSTA",
        "authorized_official_first_name": "INA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "808-537-5445",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "HI",
            "license": "MD7092",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 8, 2010; 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.