Active NPI
Clive I Otsuka, M.D.
- Internal Medicine Physician
- Honolulu, HI
National Provider Identifier
1447256094
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD4659
- Practice address
- 321 N Kuakini St
Ste 811
Honolulu, HI 96817-2362 - Phone
- (808) 531-2731
- Fax
- (808) 521-2136
- NPI assigned
- Jun 27, 2005
- Last updated
- Nov 7, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD4659 | HI | Primary |
Addresses
Primary practice location
321 N Kuakini St
Ste 811
Honolulu, HI 96817-2362
Mailing address
321 N Kuakini St
Ste 811
Honolulu, HI 96817-2362
Phone (808) 531-2731
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110114260 | Other | HI | RAILROAD MEDICARE NUMBER |
| C01334-6 | Other | HI | HMSA / BCBS NUMBER |
| 01263801 | Medicaid | HI | |
| A01334-0 | Other | HI | HMSA / BCBS NUMBER |
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: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050929000497 | HI | Practitioner - Internal Medicine | 5698700524 | Practice locations: Honolulu, HI |
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- University of Hawaii John a. Burns School of Medicine, 1980
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
321 N Kuakini St
Suite 811
Honolulu, HI 96817-2362
Phone (808) 531-2731
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD4659 | HI | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Otsuka Eye Care LLC | Past | Accepting new patients | |
| Russell Wong MD Inc | Past | Accepting new patients |
Interoperability endpoints
- clive.otsuka@28729939591172.direct.elationemr.com
- clive.otsuka@hawaiihie.medicity.net
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Medical Specialty Clinic/Center
- Honolulu, HI
- NPI 1053835520
-
- Infectious Disease Physician
- Honolulu, HI
- NPI 1780693267
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Kailua, HI
- NPI 1316937691
-
dba 15 Craigside
- Nursing Facility/Intermediate Care Facility
- Honolulu, HI
- NPI 1659658664
Nursing home
-
- Children's Hospital
- Honolulu, HI
- NPI 1043263080
-
- General Acute Care Hospital
- Honolulu, HI
- NPI 1215939335
-
- General Acute Care Hospital
- Aiea, HI
- NPI 1013961408
-
- General Acute Care Hospital
- Honolulu, HI
- NPI 1184612764
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194393600000",
"number": "1447256094",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "321 N KUAKINI ST",
"address_2": "STE 811",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968172362",
"telephone_number": "808-531-2731",
"fax_number": "808-521-2136"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "321 N KUAKINI ST",
"address_2": "STE 811",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968172362",
"telephone_number": "808-531-2731",
"fax_number": "808-521-2136"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OTSUKA",
"first_name": "CLIVE",
"middle_name": "I",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-27",
"last_updated": "2007-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "HI",
"license": "MD4659",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE NUMBER",
"identifier": "110114260",
"state": "HI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HMSA / BCBS NUMBER",
"identifier": "C01334-6",
"state": "HI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01263801",
"state": "HI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HMSA / BCBS NUMBER",
"identifier": "A01334-0",
"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 Nov 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.