Organization Active NPI

Maehara Eye Surgery & Laser LLC

  • Ophthalmology Physician
  • Waipahu, HI
National Provider Identifier
1619118718
Registry record updated Feb 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD-2131 Issued in HI
Legal business name
MAEHARA EYE SURGERY & LASER LLC
Practice address
94-239 Waipahu Depot Street
#105
Waipahu, HI 96797-3095
Phone
(808) 671-3782
Fax
(808) 671-3782
NPI assigned
Mar 19, 2009
Last updated
Feb 10, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2012

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

Authorized official

Name
Dennis I Maehara, M.D.
Title
President
Phone
(808) 671-3782

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207W00000X MD-2131 HI Primary
Ophthalmology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207W00000X MD-11924 HI

Addresses

Primary practice location

94-239 Waipahu Depot Street
#105
Waipahu, HI 96797-3095

Mailing address

94-239 Waipahu Depot Street
#105
Waipahu, HI 96797-3095
Phone (808) 671-3782

Other names 1

  • Dennis I. Maehara, M.D., Inc. Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091117000531 HI Part B Supplier - Clinic/Group Practice 5294873949 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Honolulu, HI; Waipahu, HI

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

94-239 Waipahu Depot St
Waipahu, HI 96797
Phone (808) 671-1000

94-239 Waipahu Depot St
Ste 105
Waipahu, HI 96797
Phone (808) 671-3782

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1237420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328832000000",
    "number": "1619118718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94-239 WAIPAHU DEPOT STREET",
            "address_2": "#105",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967973095",
            "telephone_number": "808-671-3782",
            "fax_number": "808-671-3782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94-239 WAIPAHU DEPOT STREET",
            "address_2": "#105",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967973095",
            "telephone_number": "808-671-3782",
            "fax_number": "808-671-3782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAEHARA EYE SURGERY & LASER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-19",
        "last_updated": "2012-02-10",
        "status": "A",
        "authorized_official_last_name": "MAEHARA",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "808-671-3782",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "HI",
            "license": "MD-2131",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "HI",
            "license": "MD-11924",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dennis I. Maehara, M.D., Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Waipahu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.