Individual provider Active NPI

Edwin Shinji Kajiwara, OD

  • Optometrist
  • Honolulu, HI
National Provider Identifier
1447215082
Registry record updated Feb 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
174 Issued in HI
Practice address
1520 Liliha St
Ste 401
Honolulu, HI 96817-3562
Phone
(808) 531-6331
Fax
(808) 531-6331
NPI assigned
Apr 18, 2006
Last updated
Feb 27, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 174 HI Primary

Addresses

Primary practice location

1520 Liliha St
Ste 401
Honolulu, HI 96817-3562

Mailing address

1520 Liliha St
Ste 401
Honolulu, HI 96817-3562
Phone (808) 531-6331

Other identifiers 2

IdentifierTypeStateIssuer
12690OtherHIHMSA
01208801MedicaidHI

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060106000330 HI Practitioner - Optometry 9537182472 Practice locations: Honolulu, HI

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
174HIMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393459200000",
    "number": "1447215082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 LILIHA ST",
            "address_2": "STE 401",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968173562",
            "telephone_number": "808-531-6331",
            "fax_number": "808-531-6331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 LILIHA ST",
            "address_2": "STE 401",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968173562",
            "telephone_number": "808-531-6331",
            "fax_number": "808-531-6331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAJIWARA",
        "first_name": "EDWIN",
        "middle_name": "SHINJI",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2014-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "HI",
            "license": "174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "12690",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01208801",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.