Individual provider Active NPI

Ken Nagahiro

  • Optometrist
  • Ewa Beach, HI
National Provider Identifier
1598717902
Registry record updated Dec 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
105 Issued in HI
Practice address
91-803 Papipi Rd
Ewa Beach, HI 96706-2438
Phone
(808) 689-7911
Fax
(808) 689-8831
NPI assigned
May 16, 2006
Last updated
Dec 17, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 105 HI Primary

Addresses

Primary practice location

91-803 Papipi Rd
Ewa Beach, HI 96706-2438

Mailing address

91-803 Papipi Rd
Ewa Beach, HI 96706-2438
Phone (808) 689-7911

Other identifiers 8

IdentifierTypeStateIssuer
0000058735OtherHIHMSA QUEST
5873-5OtherHITRICARE
5873-5OtherHIHMSA
5873-5OtherHISUMMERLIN LIFE AND HEALTH
5873-5OtherHIALOHA CARE QUEST
5873-5OtherHIHMA
05135801MedicaidHI
5873-5OtherHIHMAA

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060104000361 HI Practitioner - Optometry 4688697790 Practice locations: Ewa Beach, HI

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

91 -803 Papipi Rd
Ewa Beach, HI 96706-2438
Phone (808) 689-7911

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
105HIMDOptometrist

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229472000000",
    "number": "1598717902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91-803 PAPIPI RD",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967062438",
            "telephone_number": "808-689-7911",
            "fax_number": "808-689-8831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91-803 PAPIPI RD",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967062438",
            "telephone_number": "808-689-7911",
            "fax_number": "808-689-8831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAGAHIRO",
        "first_name": "KEN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2008-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "HI",
            "license": "105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA QUEST",
            "identifier": "0000058735",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "5873-5",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "5873-5",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUMMERLIN LIFE AND HEALTH",
            "identifier": "5873-5",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALOHA CARE QUEST",
            "identifier": "5873-5",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMA",
            "identifier": "5873-5",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05135801",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMAA",
            "identifier": "5873-5",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ewa Beach, HI

Sources for this page

Verify at the official NPI Registry.