Individual provider Active NPI

Darrell T Takebayashi, M.D.

  • Specialist
  • Honolulu, HI
National Provider Identifier
1497825624
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD5495 Issued in HI
Practice address
575 Cooke St # A2415
Honolulu, HI 96813-5274
Phone
(808) 735-9093
NPI assigned
Nov 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD5495 HI Primary

Addresses

Primary practice location

575 Cooke St # A2415
Honolulu, HI 96813-5274

Mailing address

575 Cooke St # A2415
Honolulu, HI 96813-5274
Phone (808) 735-9093

Other identifiers 1

IdentifierTypeStateIssuer
02177901MedicaidHI

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050929000304 HI Practitioner - Anesthesiology 4880629781 Reassigns benefits to 2 organizations
Practice locations: Honolulu, HI

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD5495HIMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Anesthesia, Inc CurrentSince Apr 27, 2021 Accepting new patients
Darrell Takebayashi MD LLC CurrentSince May 25, 2021 Accepting new patients
Ker-Ming Chang M D Inc Past Accepting new patients

Locations

98-1079 Moanalua Rd
Aiea, HI 96701
Phone (808) 485-4301

321 N Kuakini St
Ste 306
Honolulu, HI 96817
Phone (808) 545-1557

1301 Punchbowl St
Honolulu, HI 96813
Phone (808) 538-9011

1319 Punahou St
Honolulu, HI 96826
Phone (808) 485-4300

111 Hekili St
Ste A
Kailua, HI 96734
Phone (808) 254-8088

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497825624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 COOKE ST # A2415",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968135274",
            "telephone_number": "808-735-9093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 COOKE ST # A2415",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968135274",
            "telephone_number": "808-735-9093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAKEBAYASHI",
        "first_name": "DARRELL",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "HI",
            "license": "MD5495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02177901",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.