Organization Active NPI

Michael J Dimitrion MD Inc

  • Internal Medicine Physician
  • Aiea, HI
National Provider Identifier
1508877192
Registry record updated Jun 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MICHAEL J DIMITRION MD INC
Practice address
98-1079 Moanalua Road
Suite 420
Aiea, HI 96701
Phone
(808) 488-7770
Fax
(808) 487-0104
NPI assigned
Aug 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2011

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

Authorized official

Name
Jeannette T Tajiri
Title
Office Manager
Phone
(808) 488-7770

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

98-1079 Moanalua Road
Suite 420
Aiea, HI 96701

Mailing address

98-1079 Moanalua Road
Suite 420
Aiea, HI 96701
Phone (808) 488-7770

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040325000264 HI Part B Supplier - Clinic/Group Practice 2365334513 Receives reassigned benefits from 3 practitioners
Practice locations: Aiea, HI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308787200000",
    "number": "1508877192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98-1079 MOANALUA ROAD",
            "address_2": "SUITE 420",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "96701",
            "telephone_number": "808-488-7770",
            "fax_number": "808-487-0104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98-1079 MOANALUA ROAD",
            "address_2": "SUITE 420",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "96701",
            "telephone_number": "808-488-7770",
            "fax_number": "808-487-0104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL J DIMITRION MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2011-06-23",
        "status": "A",
        "authorized_official_last_name": "TAJIRI",
        "authorized_official_first_name": "JEANNETTE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "808-488-7770"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiea, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2011; 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.