Individual provider Active NPI

Vince Ken Yamashiroya, M.D.

  • Pediatrics Physician
  • Honolulu, HI
National Provider Identifier
1639289879
Registry record updated Feb 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD-10504 Issued in HI
Practice address
1010 S King St
Suite 105
Honolulu, HI 96814-1701
Phone
(808) 596-2030
Fax
(808) 596-2034
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD-10504 HI Primary

Addresses

Primary practice location

1010 S King St
Suite 105
Honolulu, HI 96814-1701

Mailing address

1010 S King St
Suite 105
Honolulu, HI 96814-1701
Phone (808) 596-2030

Other identifiers 1

IdentifierTypeStateIssuer
252625-01MedicaidHI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD-10504HIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vince Yamashiroya, MD, Inc. CurrentSince Feb 27, 2022 Accepting new patients

Locations

1010 S King St
Ste 105
Honolulu, HI 96814
Phone (808) 596-2030

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645660800000",
    "number": "1639289879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 S KING ST",
            "address_2": "SUITE 105",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968141701",
            "telephone_number": "808-596-2030",
            "fax_number": "808-596-2034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 S KING ST",
            "address_2": "SUITE 105",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968141701",
            "telephone_number": "808-596-2030",
            "fax_number": "808-596-2034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAMASHIROYA",
        "first_name": "VINCE",
        "middle_name": "KEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "HI",
            "license": "MD-10504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "252625-01",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.