NPIMap

Organization Active NPI

Robb T. Shibayama, O.D., Inc.

  • Optometrist
  • Pearl City, HI
National Provider Identifier
1629125752
Registry record updated Oct 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD 529 Issued in HI
Legal business name
ROBB T. SHIBAYAMA, O.D., INC.
Practice address
1000 Kamehameha Hwy Ste 100
Pearl City, HI 96782-2596
Phone
(808) 456-3937
Fax
(808) 454-0683
NPI assigned
Jan 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2012

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

Authorized official

Name
Dr. Robb T. Shibayama, O.D.NPI 1942357843
Title
Owner
Phone
(808) 225-7622

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OD 529 HI Primary

Addresses

Primary practice location

1000 Kamehameha Hwy Ste 100
Pearl City, HI 96782-2596

Mailing address

1228 Ala Aupaka PL
Honolulu, HI 96818-2232
Phone (808) 225-7622

Other identifiers 1

IdentifierTypeStateIssuer
H53236OtherHIMEDICARE PTAN

Other names 1

  • Hawaii Vision Associates Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040323000606 HI Part B Supplier - Clinic/Group Practice 6002707643 Receives reassigned benefits from 10 practitioners
2 other NPIs on this enrollment
Practice locations: Aiea, HI; Honolulu, HI; Pearl City, HI

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
Robb T Shibayama OD Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 10

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": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350432000000",
    "number": "1629125752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1228 ALA AUPAKA PL",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968182232",
            "telephone_number": "808-225-7622",
            "fax_number": "808-454-0683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 KAMEHAMEHA HWY STE 100",
            "city": "PEARL CITY",
            "state": "HI",
            "postal_code": "967822596",
            "telephone_number": "808-456-3937",
            "fax_number": "808-454-0683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBB T. SHIBAYAMA, O.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2012-10-17",
        "status": "A",
        "authorized_official_last_name": "SHIBAYAMA",
        "authorized_official_first_name": "ROBB",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-225-7622",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "HI",
            "license": "OD 529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "H53236",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hawaii Vision Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pearl City, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.