Individual provider Active NPI

Gary W Ahn, MD

  • Sports Medicine (Internal Medicine) Physician
  • Honolulu, HI
National Provider Identifier
1639260441
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0010X
License
MD7115 Issued in HI
Practice address
377 Keahole St
Honolulu, HI 96825-3405
Phone
(808) 396-6675
Fax
(808) 395-2104
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Internal Medicine) Physician 207RS0010X MD7115 HI Primary

Addresses

Primary practice location

377 Keahole St
Honolulu, HI 96825-3405

Mailing address

838 S Beretania St
Suite 307
Honolulu, HI 96813-2524
Phone (808) 547-4600

Other identifiers 1

IdentifierTypeStateIssuer
068133MedicaidHI

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061212000117 HI Practitioner - HospitalistPractitioner - Internal Medicine 6901805431 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
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

  • The Queens Medical Center Hospital, Honolulu, HI, CCN 120001

Merit-based Incentive Payment System (MIPS)

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

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Queens University Medical Group CurrentSince Apr 22, 2022 Accepting new patients
The Queen'S Medical Center CurrentSince Jan 1, 2017 Accepting new patients
The Queens Medical Center CurrentSince Jan 1, 2017 Accepting new patients

Locations

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

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

377 Keahole St
Honolulu, HI 96825
Phone (808) 395-4427

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

575 Farrington Hwy
Kapolei, HI 96707
Phone (808) 674-4006

599 Farrington Hwy
Ste 201
Kapolei, HI 96707
Phone (808) 674-9500

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639260441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "838 S BERETANIA ST",
            "address_2": "SUITE 307",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132524",
            "telephone_number": "808-547-4600",
            "fax_number": "808-547-4559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "377 KEAHOLE ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968253405",
            "telephone_number": "808-396-6675",
            "fax_number": "808-395-2104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHN",
        "first_name": "GARY",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RS0010X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sports Medicine",
            "state": "HI",
            "license": "MD7115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "068133",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.