Individual provider Active NPI

Ryan Anthony Fisicaro, M.D.

  • Diagnostic Radiology Physician
  • Honolulu, HI
National Provider Identifier
1639529910
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD24354 Issued in HI
Practice address
1301 Punchbowl St
Honolulu, HI 96813-2499
Phone
(808) 691-1000
NPI assigned
Jun 16, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MT211183 PA
Diagnostic Radiology Physician 2085R0202X MD24354 HI Primary

Addresses

Primary practice location

1301 Punchbowl St
Honolulu, HI 96813-2499

Mailing address

5501 Old York Rd
Albert Einstein Medical Center
Philadelphia, PA 19141-3018
Phone (215) 456-7890

Other practice location 1

5501 Old York Rd
Albert Einstein Medical Center
Philadelphia, PA 19141-3018
Phone (215) 456-7890

Other identifiers 1

IdentifierTypeStateIssuer
MT211183OtherPAMEDICAL TRAINING LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, HI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230209002726 CA Practitioner - Diagnostic Radiology 2961874474 Reassigns benefits to 2 organizations
I20240701001178 HI Practitioner - Diagnostic Radiology 2961874474 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Texas Southwestern Medical School at Dallas, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Queens University Medical GroupGroup PAC ID 2466831557, 614 clinicians
Queens North Hawaii Community HospitalGroup PAC ID 0143116293, 102 clinicians

Practice addresses (Care Compare)

1301 Punchbowl St
Honolulu, HI 96813-2402
Phone (808) 691-1000

67-1125 Mamalaho Hwy
Kamuela, HI 96743-8496
Phone (808) 881-4400

Hospital & facility affiliations

  • The Queens Medical Center Hospital, Honolulu, HI, CCN 120001
  • North Hawaii Community Hospital, Inc Hospital, Kamuela, HI, CCN 120028
  • Kuakini Medical Center Hospital, Honolulu, HI, CCN 120007

Merit-based Incentive Payment System (MIPS)

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

Merit-based Incentive Payment System (MIPS)

Final score
87.01 of 100Reported as group
Quality
86.78
Improvement activities
40
Cost
70.46

Merit-based Incentive Payment System (MIPS)

Final score
84.89 of 100Reported as group
Quality
81.13
Improvement activities
40
Cost
71.5

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD24354HIMDDiagnostic Radiology Physician
MT211183PAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Queens North Hawaii Community Hospital CurrentSince Aug 1, 2024 Accepting new patients
University of California San Francisco CurrentSince Jun 30, 2023 Accepting new patients
Queens University Medical Group CurrentSince Aug 1, 2024 Accepting new patients
UCSF Medical Group Business Services CurrentSince Jun 30, 2023 Accepting new patients
UCSF Medical Group Business Services CurrentSince Jun 30, 2023 Accepting new patients
University of California San Francisco CurrentSince Jun 30, 2023 Accepting new patients

Locations

3100 San Pablo Ave
Berkeley, CA 94702
Phone (510) 985-5020

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

2001 The Embarcadero
Ste 1500
San Francisco, CA 94143
Phone (415) 353-1606

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

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

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

67-1125 Mamalahoa Hwy
Kamuela, HI 96743
Phone (808) 881-4400

Interoperability endpoints

  • Direct secure messaging: rfisicaro81054@direct.phhs.org

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1466035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1639529910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 OLD YORK RD",
            "address_2": "ALBERT EINSTEIN MEDICAL CENTER",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413018",
            "telephone_number": "215-456-7890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 PUNCHBOWL ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132499",
            "telephone_number": "808-691-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5501 Old York Rd",
            "address_2": "Albert Einstein Medical Center",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191413018",
            "country_code": "US",
            "telephone_number": "215-456-7890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FISICARO",
        "first_name": "RYAN",
        "middle_name": "ANTHONY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-16",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MT211183",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "HI",
            "license": "MD24354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL TRAINING LICENSE NUMBER",
            "identifier": "MT211183",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.