Individual provider Active NPI

Lizette Calubana Aquino-Bautista, OD

  • Optometrist
  • Waipahu, HI
National Provider Identifier
1659065456
Registry record updated Jun 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1007 Issued in HI
Practice address
94-428 Mokuola St Ste 102
Waipahu, HI 96797-3396
Phone
(808) 677-7222
Fax
(808) 677-3300
NPI assigned
Jun 5, 2023
Last updated
Jun 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1007 HI Primary

Addresses

Primary practice location

94-428 Mokuola St Ste 102
Waipahu, HI 96797-3396

Mailing address

405 N Kuakini St Ste 605
Honolulu, HI 96817-6302
Phone (808) 456-3937

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
I20230613003648 HI Practitioner - Optometry 5395103980 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vision Care Center of Hawaii LLCGroup PAC ID 2062802044, 5 clinicians

Practice addresses (Care Compare)

94-050 Farrington Hwy
Suite B1 1
Waipahu, HI 96797-1800
Phone (808) 677-1544

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1007HIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Wendi N Harada OD Inc Optometrist CurrentSince Jul 1, 2023 Accepting new patients
Calvin Alonzo OD, Inc Optometrist CurrentSince Jul 1, 2023 Accepting new patients
Wendi N. Harada, O.D., Inc. Optometrist CurrentSince Jul 1, 2023 Accepting new patients
Robb T. Shibayama, O.D., Inc Optometrist CurrentSince Jul 1, 2023 Accepting new patients
Robb T. Shibayama, O.D., Inc. Optometrist CurrentSince Jul 1, 2023 Accepting new patients
Vision Care Center of Hawaii LLC Optometrist CurrentSince Jun 2, 2025 Accepting new patients
Calvin Alonzo, O.D., Inc Optometrist CurrentSince Jun 11, 2023 Accepting new patients
Roger Christian Ede, O.D., Inc. Optometrist PastSince Jun 2, 2025 Accepting new patients

Locations

1450 Ala Moana Blvd
Ste 1300
Honolulu, HI 96814
Phone (808) 492-5066

405 N Kuakini St
Ste 605
Honolulu, HI 96817
Phone (808) 225-7622

750 Keeaumoku St
Honolulu, HI 96814
Phone (808) 941-6719

46-056 Kamehameha Hwy
Kaneohe, HI 96744
Phone (808) 235-1884

91-600 Farrington Hwy
Unit 3
Kapolei, HI 96707
Phone (808) 674-4488

1000 Kamehameha Hwy
Ste 100
Pearl City, HI 96782
Phone (808) 454-0182

94-050 Farrington Hwy
Ste B1-1
Waipahu, HI 96797
Phone (808) 677-1544

94-050 Farrington Hwy
Ste B11
Waipahu, HI 96797
Phone (808) 677-1544

94-428 Mokuola St
Ste 102
Waipahu, HI 96797
Phone (808) 371-0577

Organizations & group practices 8

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": "1685923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1659065456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 N KUAKINI ST STE 605",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968176302",
            "telephone_number": "808-456-3937",
            "fax_number": "808-425-4706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94-428 MOKUOLA ST STE 102",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967973396",
            "telephone_number": "808-677-7222",
            "fax_number": "808-677-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AQUINO-BAUTISTA",
        "first_name": "LIZETTE",
        "middle_name": "CALUBANA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-05",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "HI",
            "license": "1007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waipahu, HI

Sources for this page

Verify at the official NPI Registry.