Organization Active NPI

Hawaii PM&R

  • Physical Medicine & Rehabilitation Physician
  • Honolulu, HI
National Provider Identifier
1477922185
Registry record updated Sep 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
17167 Issued in HI
Legal business name
HAWAII PM&R
Practice address
1125 Young St Apt 806
Honolulu, HI 96814-1972
Phone
(808) 931-9167
NPI assigned
Sep 23, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2015

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

Authorized official

Name
Dr. Tamara Kollarova, M.D.NPI 1831364843
Title
Physician
Phone
(808) 931-9167

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
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X 17167 HI Primary

Addresses

Primary practice location

1125 Young St Apt 806
Honolulu, HI 96814-1972

Mailing address

1125 Young St Apt 806
Honolulu, HI 96814-1972
Phone (808) 931-9167

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160128000608 HI Part B Supplier - Clinic/Group Practice 9739482589 Receives reassigned benefits from 1 practitioner
Practice locations: Honolulu, HI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1442966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442966400000",
    "number": "1477922185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 YOUNG ST APT 806",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968141972",
            "telephone_number": "808-931-9167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 YOUNG ST APT 806",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968141972",
            "telephone_number": "808-931-9167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAWAII PM&R",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-23",
        "last_updated": "2015-09-23",
        "status": "A",
        "authorized_official_last_name": "KOLLAROVA",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "808-931-9167",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "HI",
            "license": "17167",
            "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 Sep 23, 2015; 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.