Individual provider Active NPI

Scott Ninomiya, APRN

  • Pediatric Nurse Practitioner
  • Honolulu, HI
National Provider Identifier
1548614043
Registry record updated Apr 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
1683 Issued in HI
Practice address
1319 Punahou St
Honolulu, HI 96826-1001
Phone
(808) 983-8279
Fax
(808) 983-6408
NPI assigned
Apr 20, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 1683 HI Primary

Addresses

Primary practice location

1319 Punahou St
Honolulu, HI 96826-1001

Mailing address

1319 Punahou St
Honolulu, HI 96826-1001
Phone (808) 983-8279

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200109000180 HI Practitioner - Nurse Practitioner 9931534583 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1319 Punahou St
Honolulu, HI 96826-1001
Phone (808) 983-6000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1683HIMDPediatric Nurse Practitioner

Organizations & group practices 1

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": "1461110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461110400000",
    "number": "1548614043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1319 PUNAHOU ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968261001",
            "telephone_number": "808-983-8279",
            "fax_number": "808-983-6408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1319 PUNAHOU ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968261001",
            "telephone_number": "808-983-8279",
            "fax_number": "808-983-6408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NINOMIYA",
        "first_name": "SCOTT",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-20",
        "last_updated": "2016-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "HI",
            "license": "1683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.