Antonin Jaros, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

19943 Issued in HI

Practice address

105 Maui Lani Pkwy Ste 100
Wailuku, HI 96793-2443

Phone

(480) 740-2106

NPI assigned

Apr 25, 2006

Last updated

Apr 6, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ, 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Maui Health System a Kaiser Foundation Hospitals LLC

  dba Maui Memorial Medical Center

  • General Acute Care Hospital
  • Wailuku, HI
  • NPI 1013379460
  Medicare reassignment NPD
• Affiliated Hospitalists, PLC

  • Hospitalist Physician
  • Phoenix, AZ
  • NPI 1265546261

  Internal Medicine

  Medicare reassignment NPD
• Maui Kidney Center LLC

  • Nephrology Physician
  • Wailuku, HI
  • NPI 1770054355
  Authorized official Same address or phone
• Maui Health System a Kaiser Foundation Hospitals LLC

  dba Lanai Community Hospital

  • Critical Access Hospital
  • Lanai City, HI
  • NPI 1336501634
  NPD
• Maui Health System a Kaiser Foundation Hospitals LLC

  • Specialist
  • Wailuku, HI
  • NPI 1669834016
  NPD

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554508800000",
    "number": "1669438842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 MAUI LANI PKWY STE 100",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967932443",
            "telephone_number": "480-740-2106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 MAUI LANI PKWY STE 100",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967932443",
            "telephone_number": "480-740-2106"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 University Of New Mexico",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871310001",
            "country_code": "US",
            "telephone_number": "505-272-0407",
            "fax_number": "505-272-0598",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAROS",
        "first_name": "ANTONIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2019-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "31852",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "HI",
            "license": "19943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "862898-01",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Island Mind Therapy LLC
• Island Podiatry, LLC
• J Jancaterino LLC
• J. Glenn Haines, M.D., Inc.
• Jon S Jancaterino, MD
• Beth Jarrett, MD
• Jodi Kimberly Jaslow, MA
• Jasmine Rivera
• Melody Brooks Jayne, MD
• Jeanette Evans, Inc.

• Nephrology Physician in Wailuku, HI
• Providers in Wailuku, HI by specialty
• Nephrology Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.