Individual provider Active NPI

Carrie C Hisatomi, LAC

  • Acupuncturist
  • Makawao, HI
National Provider Identifier
1467538066
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
ACU874 Issued in HI
Practice address
1135 Makawao Ave Ste 101
Makawao, HI 96768-7401
Phone
(808) 268-8460
NPI assigned
Oct 27, 2006
Last updated
Oct 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X ACU874 HI Primary

Addresses

Primary practice location

1135 Makawao Ave Ste 101
Makawao, HI 96768-7401

Mailing address

PO Box 127
Makawao, HI 96768-0127
Phone (808) 268-8460

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
ACU874HIMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Jade Acupuncture Acupuncturist Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1467538066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 127",
            "city": "MAKAWAO",
            "state": "HI",
            "postal_code": "967680127",
            "telephone_number": "808-268-8460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 MAKAWAO AVE STE 101",
            "city": "MAKAWAO",
            "state": "HI",
            "postal_code": "967687401",
            "telephone_number": "808-268-8460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HISATOMI",
        "first_name": "CARRIE",
        "middle_name": "C",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "HI",
            "license": "ACU874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Makawao, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2024; 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.