NPIMap

Organization Active NPI

Robert L. Peterson, Inc.

  • Plastic Surgery Physician
  • Honolulu, HI
National Provider Identifier
1598719916
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
MD7087 Issued in HI
Legal business name
ROBERT L. PETERSON, INC.
Doing business as
Athena Group
Practice address
1319 Punahou St
#1070
Honolulu, HI 96826-1001
Phone
(808) 944-8557
Fax
(808) 955-5667
NPI assigned
May 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Robert L Peterson, M.D.NPI 1407905524
Title
Owner
Phone
(808) 944-8551

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)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208200000X MD7087 HI Primary

Addresses

Primary practice location

1319 Punahou St
#1070
Honolulu, HI 96826-1001

Mailing address

1319 Punahou St
#1070
Honolulu, HI 96826-1001
Phone (808) 944-8557

Other identifiers 3

IdentifierTypeStateIssuer
91264OtherHIBLUE CROSS BLUE SHEILD
91264MedicaidHI
MD7087OtherHIQUEENS HEALTH CARE

Other names 1

  • Athena Group Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1598719916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1319 PUNAHOU ST",
            "address_2": "#1070",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968261001",
            "telephone_number": "808-944-8557",
            "fax_number": "808-955-5667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1319 PUNAHOU ST",
            "address_2": "#1070",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968261001",
            "telephone_number": "808-944-8557",
            "fax_number": "808-955-5667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT L. PETERSON, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-944-8551",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": "HI",
            "license": "MD7087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "91264",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "91264",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUEENS HEALTH CARE",
            "identifier": "MD7087",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Athena Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.