Active NPI
Ultracare Diagnostic Imaging, LLC
- Radiology Clinic/Center
- Kailua, HI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiology Clinic/Center
- Legal business name
- ULTRACARE DIAGNOSTIC IMAGING, LLC
- Practice address
- 122 Oneawa St Ste 102
Kailua, HI 96734-2524 - Phone
- (808) 354-3510
- NPI assigned
- Aug 4, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Deborah Hazelbaker, RDMS
- Title
- Owner
- Phone
- (808) 354-3510
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiology Clinic/Center | 261QR0200X | Primary |
Addresses
Primary practice location
122 Oneawa St Ste 102
Kailua, HI 96734-2524
Mailing address
122 Oneawa St Ste 102
Kailua, HI 96734-2524
Phone (808) 354-3510
Other practice location 1
425 G St
Suite 620
Anchorage, AK 99501-2140
Phone (907) 538-4139
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619101 | Medicaid | AK |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | HONOLULU | Direct | |
| CONNECT URL | HONOLULU | Direct |
National Provider Directory
National Provider DirectoryLocations
4050 Lake Otis Pkwy
Ste 10
Anchorage, AK 99508
425 G St
Ste 620
Anchorage, AK 99501
Phone (907) 538-4139
44539 Sterling Hwy
Ste 108
Soldotna, AK 99669
Phone (907) 538-4139
122 Oneawa St
Ste 102
Kailua, HI 96734
Phone (808) 354-3510
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Other Specialist/Technologist
- Titusville, FL
- NPI 1477782274
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407110400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1613692800000",
"number": "1558770651",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "122 ONEAWA ST STE 102",
"city": "KAILUA",
"state": "HI",
"postal_code": "967342524",
"telephone_number": "808-354-3510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "122 ONEAWA ST STE 102",
"city": "KAILUA",
"state": "HI",
"postal_code": "967342524",
"telephone_number": "808-354-3510"
}
],
"practiceLocations": [
{
"address_1": "425 G St",
"address_2": "Suite 620",
"address_purpose": "LOCATION",
"city": "Anchorage",
"state": "AK",
"postal_code": "995012140",
"country_code": "US",
"telephone_number": "907-538-4139",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "ULTRACARE DIAGNOSTIC IMAGING, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2014-08-04",
"last_updated": "2021-02-19",
"certification_date": "2021-02-19",
"status": "A",
"authorized_official_last_name": "HAZELBAKER",
"authorized_official_first_name": "DEBORAH",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "808-354-3510",
"authorized_official_credential": "RDMS"
},
"taxonomies": [
{
"code": "261QR0200X",
"taxonomy_group": "",
"desc": "Clinic/Center, Radiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1619101",
"state": "AK"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "HONOLULU",
"affiliation": "N",
"endpointDescription": "1558770651",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1009 Kapiolani Blvd Apt 4707",
"city": "Honolulu",
"state": "HI",
"country_code": "US",
"postal_code": "968142189",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "HONOLULU",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1009 Kapiolani Blvd Apt 4707",
"city": "Honolulu",
"state": "HI",
"country_code": "US",
"postal_code": "968142189",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Kailua, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.