Individual provider Active NPI

Jan V Levitan, MD

  • Diagnostic Radiology Physician
  • Kamuela, HI
National Provider Identifier
1528044922
Registry record updated Jan 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD-7319 Issued in HI
Practice address
67-1125 Mamalahoa Hwy
Kamuela, HI 96743-8496
Phone
(808) 881-4880
NPI assigned
Dec 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 35.090752 OH
Diagnostic Radiology Physician 2085R0202X MD-7319 HI Primary

Addresses

Primary practice location

67-1125 Mamalahoa Hwy
Kamuela, HI 96743-8496

Mailing address

59-320 Pualele PL
Kamuela, HI 96743-8530
Phone (808) 880-9789

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
I20080411000480 HI Practitioner - Diagnostic Radiology 7214828870 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-7319HIMDDiagnostic Radiology Physician
35.090752OHMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinic Medical Services Company LLC Diagnostic Radiology CurrentSince Jan 1, 2008 Accepting new patients
Clinic Medical Services Company Diagnostic Radiology CurrentSince Jan 1, 2008 Accepting new patients
Carolina Radiology Associates LLC Diagnostic Radiology Past Accepting new patients
Coastal Plains Physician Associates Diagnostic Radiology Past Accepting new patients
Charleston Radiologists PA Diagnostic Radiology Past Accepting new patients
Blue Ridge Radiology, P.C. Diagnostic Radiology Past Accepting new patients

Locations

67-1125 Mamalahoa Hwy
Kamuela, HI 96743
Phone (808) 881-4400

2420 Lake Ave
Ashtabula, OH 44004
Phone (216) 986-2919

1730 W 25th St
Cleveland, OH 44113
Phone (216) 696-4300

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

12300 McCracken Rd
Garfield Hts, OH 44125
Phone (216) 581-0500

6780 Mayfield Rd
Mayfield Hts, OH 44124
Phone (440) 331-9520

1740 Cleveland Rd
Wooster, OH 44691
Phone (330) 287-4500

Organizations & group practices 7

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": "1134691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199923200000",
    "number": "1528044922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59-320 PUALELE PL",
            "city": "KAMUELA",
            "state": "HI",
            "postal_code": "967438530",
            "telephone_number": "808-880-9789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67-1125 MAMALAHOA HWY",
            "city": "KAMUELA",
            "state": "HI",
            "postal_code": "967438496",
            "telephone_number": "808-881-4880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVITAN",
        "first_name": "JAN",
        "middle_name": "V",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-16",
        "last_updated": "2008-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35.090752",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "HI",
            "license": "MD-7319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kamuela, HI

Sources for this page

Verify at the official NPI Registry.