Individual provider Active NPI

Jeffrey M Lau, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Honolulu, HI
National Provider Identifier
1629056320
Registry record updated Feb 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
MD3795 Issued in HI
Practice address
1329 Lusitana St
Suite 108
Honolulu, HI 96813-2429
Phone
(808) 537-1974
Fax
(808) 537-1976
NPI assigned
Jan 4, 2006
Last updated
Feb 13, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X MD3795 HI Primary

Addresses

Primary practice location

1329 Lusitana St
Suite 108
Honolulu, HI 96813-2429

Mailing address

1329 Lusitana St
Suite 108
Honolulu, HI 96813
Phone (808) 537-1974

Other identifiers 2

IdentifierTypeStateIssuer
04790401MedicaidHI
N54527OtherHIHMSA

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051102000073 HI Practitioner - Thoracic SurgeryPractitioner - Cardiac SurgeryPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Vascular Surgery 5294752838 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3795HIMDClinical Social Worker
MD3795HIMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Queens Medical Center CurrentSince May 20, 2012 Accepting new patients
The Queen's Medical Center CurrentSince May 20, 2012 Accepting new patients

Locations

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

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

Organizations & group practices 3

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": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360713600000",
    "number": "1629056320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1329 LUSITANA ST",
            "address_2": "SUITE 108",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "96813",
            "telephone_number": "808-537-1974",
            "fax_number": "808-537-1976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1329 LUSITANA ST",
            "address_2": "SUITE 108",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132429",
            "telephone_number": "808-537-1974",
            "fax_number": "808-537-1976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAU",
        "first_name": "JEFFREY",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-04",
        "last_updated": "2013-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "HI",
            "license": "MD3795",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04790401",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "N54527",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.