Individual provider Active NPI

Wesley Jitsuo Sugai, M.D.

  • Pediatrics Physician
  • Kailua Kona, HI
National Provider Identifier
1548435787
Registry record updated Jan 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
5336 Issued in HI
Practice address
78-6831 Alii Dr Ste 328
Kailua Kona, HI 96740-4408
Phone
(808) 329-7719
Fax
(808) 329-7518
NPI assigned
Apr 29, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 5336 HI Primary

Addresses

Primary practice location

78-6831 Alii Dr Ste 328
Kailua Kona, HI 96740-4408

Mailing address

78-6831 Alii Dr Ste 328
Kailua Kona, HI 96740-4408
Phone (808) 329-7719

Other identifiers 1

IdentifierTypeStateIssuer
022065MedicaidHI

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
I20200109002009 HI Practitioner - Pediatric Medicine 7113352691 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5336HIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alii Health Center CurrentSince Dec 1, 2019 Accepting new patients
Ali'I Health Center CurrentSince Dec 1, 2019 Accepting new patients
Alii Health Center PastSince Feb 14, 2021 Accepting new patients
Wesley J. Sugai, M.D., Inc. Pediatrics Past Accepting new patients

Locations

78-6831 Alii Dr
Ste 418
Kailua Kona, HI 96740
Phone (808) 747-8725

78-6831 Alii Dr
Ste 411
Kailua Kona, HI 96740
Phone (808) 636-6393

78-6831 Alii Dr
Ste 422
Kailua Kona, HI 96740
Phone (808) 747-8321

78-6831 Alii Dr
Ste 328
Kailua Kona, HI 96740
Phone (808) 747-8321

Organizations & group practices 4

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": "1209427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579132800000",
    "number": "1548435787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78-6831 ALII DR STE 328",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967404408",
            "telephone_number": "808-329-7719",
            "fax_number": "808-329-7518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78-6831 ALII DR STE 328",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967404408",
            "telephone_number": "808-329-7719",
            "fax_number": "808-329-7518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUGAI",
        "first_name": "WESLEY",
        "middle_name": "JITSUO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-29",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "HI",
            "license": "5336",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022065",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kailua Kona, HI

Sources for this page

Verify at the official NPI Registry.