Junedale Yuka Nishiyama, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A95075 Issued in CA

Practice address

Warrior Ohana Medical Home 91-1010 Shangrila St
Ste 500
Kapolei, HI 96707-2176

Phone

(808) 433-5420

Fax

(808) 682-4001

NPI assigned

May 2, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: junedale.nishiyama.1@19917.direct.athenahealth.com

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702598400000",
    "number": "1548482623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "TRIPLER ARMY MEDICAL CENTER 1 JARRETT WHITE RD",
            "city": "TRIPLER AMC",
            "state": "HI",
            "postal_code": "968595001",
            "telephone_number": "808-433-5420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WARRIOR OHANA MEDICAL HOME 91-1010 SHANGRILA ST",
            "address_2": "STE 500",
            "city": "KAPOLEI",
            "state": "HI",
            "postal_code": "967072176",
            "telephone_number": "808-433-5420",
            "fax_number": "808-682-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISHIYAMA",
        "first_name": "JUNEDALE",
        "middle_name": "YUKA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A95075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "MD 15473",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chenoah Lin Couvillion Nigrelli, MS, ATC
• Ani G Nikolova, PH.D., LBA, BCBA-D
• Jason Takemi Ninomiya, M.D.
• Kira Niotta
• Shaye Nishimura
• Roy Kaikalani Nitahara Jr.
• Nanea Nomura
• Amanda Faye Northup, MD
• Sasha Numazu-Fisher
• Nurses Just for Kids, Inc

• Family Medicine Physician in Kapolei, HI
• Providers in Kapolei, HI by specialty
• Family Medicine Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.