NPIMap

Organization Active NPI

Keith T Matsumoto MD Inc

  • Pediatrics Physician
  • Honolulu, HI
National Provider Identifier
1659454635
Registry record updated Jun 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4464 Issued in HI
Legal business name
KEITH T MATSUMOTO MD INC
Practice address
1319 Punahou St
Suite 900
Honolulu, HI 96826-1032
Phone
(808) 949-0011
Fax
(808) 943-2536
NPI assigned
Oct 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2014

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

Authorized official

Name
Keith Tsugio Matsumoto, MDNPI 1366858953
Title
President
Phone
(808) 949-0011

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
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 4464 HI Primary

Addresses

Primary practice location

1319 Punahou St
Suite 900
Honolulu, HI 96826-1032

Mailing address

1319 Punahou St
Suite 900
Honolulu, HI 96826-1032
Phone (808) 949-0011

Other identifiers 5

IdentifierTypeStateIssuer
00D0011215OtherHMSA QUEST
01076801MedicaidHI
194670OtherHMN
00D0011215OtherHMSA
MD446401OtherQUEENS HEALTH CARE

National Provider Directory

National Provider Directory

Locations

1319 Punahou St
Ste 900
Honolulu, HI 96826
Phone (808) 949-0011

Practitioners & affiliated clinicians

Practitioners 2

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": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403136000000",
    "number": "1659454635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1319 PUNAHOU ST",
            "address_2": "SUITE 900",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968261032",
            "telephone_number": "808-949-0011",
            "fax_number": "808-943-2536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1319 PUNAHOU ST",
            "address_2": "SUITE 900",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968261032",
            "telephone_number": "808-949-0011",
            "fax_number": "808-943-2536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEITH T MATSUMOTO MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2014-06-19",
        "status": "A",
        "authorized_official_last_name": "MATSUMOTO",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "TSUGIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "808-949-0011",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "HI",
            "license": "4464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA QUEST",
            "identifier": "00D0011215",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01076801",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMN",
            "identifier": "194670",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "00D0011215",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUEENS HEALTH CARE",
            "identifier": "MD446401",
            "state": null
        }
    ],
    "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 Jun 19, 2014; 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.