Individual provider Active NPI

Mark Andrew Apana Lum

  • Student in an Organized Health Care Education/Training Program
  • Honolulu, HI
National Provider Identifier
1568858850
Registry record updated Sep 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1380 Lusitana St Ste 1007a
Honolulu, HI 96813-2461
Phone
(808) 748-4700
NPI assigned
Apr 13, 2015
Last updated
Sep 28, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary

Addresses

Primary practice location

1380 Lusitana St Ste 1007a
Honolulu, HI 96813-2461

Mailing address

3600 Broadway
Oakland, CA 94611-5730

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
I20210623003025 HI Practitioner - Diagnostic Radiology 4284972407 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of California, San Francisco School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hawaii Permanente Medical Group IncGroup PAC ID 7618880667, 705 clinicians

Practice addresses (Care Compare)

3288 Moanalua Rd
Honolulu, HI 96819-1469
Phone (808) 432-0000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Associates, Inc CurrentSince Aug 2, 2021 Accepting new patients
Queens North Hawaii Community Hospital CurrentSince Jul 1, 2023 Accepting new patients
Hawaii Permanente Medical Group Inc CurrentSince Oct 9, 2023 Accepting new patients
North Hawaii Community Hospital CurrentSince Jul 1, 2023 Accepting new patients
Queens University Medical Group CurrentSince Jul 1, 2023 Accepting new patients
John J Cogan MD Inc Past Accepting new patients

Locations

1301 Punchbowl St
Honolulu, HI 96813
Phone (808) 538-9011

1380 Lusitana St
Ste 1007A
Honolulu, HI 96813
Phone (716) 725-3116

1380 Lusitana St
Ste 913
Honolulu, HI 96813
Phone (808) 691-8521

3288 Moanalua Rd
Honolulu, HI 96819
Phone (808) 265-9205

711 Kapiolani Blvd
Honolulu, HI 96813
Phone (808) 432-5312

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

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1428883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601251200000",
    "number": "1568858850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 BROADWAY",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946115730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 LUSITANA ST STE 1007A",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132461",
            "telephone_number": "808-748-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUM",
        "first_name": "MARK",
        "middle_name": "ANDREW APANA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-13",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.