NPIMap

Individual provider Active NPI

Lance K. Mitsunaga, MD

  • Orthopaedic Surgery Physician
  • Honolulu, HI
National Provider Identifier
1619139128
Registry record updated May 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
17797 Issued in HI
Practice address
1380 Lusitana St
Suite 905
Honolulu, HI 96813-2449
Phone
(808) 522-9633
Fax
(808) 522-9646
NPI assigned
Jun 26, 2008
Last updated
May 10, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 17797 HI Primary

Addresses

Primary practice location

1380 Lusitana St
Suite 905
Honolulu, HI 96813-2449

Mailing address

1380 Lusitana St
Suite 905
Honolulu, HI 96813-2449
Phone (808) 522-9633

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150526001241 HI Practitioner - Orthopedic Surgery 5991932311 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of California, San Diego School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Queens University Medical GroupGroup PAC ID 2466831557, 614 clinicians

Practice addresses (Care Compare)

1301 Punchbowl St
Honolulu, HI 96813-2499

1380 Lusitana St
Honolulu, HI 96813-2448

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.05 of 100Reported as apm
Quality
89.81
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion100
Laminectomy or laminotomy (partial removal of spine bones)96

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17797HIMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Queens Medical Center CurrentSince Mar 1, 2021 Accepting new patients
The Queens Medical Center CurrentSince Mar 1, 2021 Accepting new patients
The Queen's Medical Center Current Accepting new patients
Queens University Medical Group CurrentSince Apr 22, 2022 Accepting new patients
Shriners Hospitals for Children CurrentSince Aug 29, 2023 Accepting new patients
Shriners Hospitals for Children Past Accepting new patients

Locations

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

1310 Punahou St
Honolulu, HI 96826
Phone (808) 941-4466

1380 Lusitana St
Ste 905
Honolulu, HI 96813
Phone (808) 522-9633

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

550 S Beretania St
Ste 404
Honolulu, HI 96813
Phone (808) 691-8897

550 S Beretania St
Ste 703
Honolulu, HI 96813
Phone (808) 691-4211

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 5

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": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494374400000",
    "number": "1619139128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 LUSITANA ST",
            "address_2": "SUITE 905",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132449",
            "telephone_number": "808-522-9633",
            "fax_number": "808-522-9646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 LUSITANA ST",
            "address_2": "SUITE 905",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132449",
            "telephone_number": "808-522-9633",
            "fax_number": "808-522-9646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITSUNAGA",
        "first_name": "LANCE",
        "middle_name": "K.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-26",
        "last_updated": "2017-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "HI",
            "license": "17797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.