Individual provider Active NPI

Peter Matsumoto, PH2847

  • Pharmacist
  • Honolulu, HI
National Provider Identifier
1609143791
Registry record updated Mar 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH-2847 Issued in HI
Practice address
1488 Kapiolani Blvd
Honolulu, HI 96814-3716
Phone
(808) 949-8500
NPI assigned
Nov 17, 2011
Last updated
Mar 29, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH-2847 HI Primary

Addresses

Primary practice location

1488 Kapiolani Blvd
Honolulu, HI 96814-3716

Mailing address

1488 Kapiolani Blvd
Honolulu, HI 96814-3716

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PH-2847HIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co Past Accepting new patients

Organizations & group practices 2

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": "1321488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364515200000",
    "number": "1609143791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1488 KAPIOLANI BLVD",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968143716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1488 KAPIOLANI BLVD",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968143716",
            "telephone_number": "808-949-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATSUMOTO",
        "first_name": "PETER",
        "credential": "PH2847",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-17",
        "last_updated": "2013-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "HI",
            "license": "PH-2847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Mar 29, 2013; 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.