Individual provider Active NPI

Timothy Joseph Keene, MD

  • Family Medicine Physician
  • Honolulu, HI
National Provider Identifier
1679132344
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD-23502 Issued in HI
Practice address
449 Kapahulu Ave Ste 104
Honolulu, HI 96815-3850
Phone
(808) 735-0007
NPI assigned
Jun 6, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 21469 NV
General Practice Physician 208D00000X 21469 NV
Hospitalist Physician 208M00000X 21469 NV
Family Medicine Physician 207Q00000X MD-23502 HI Primary

Addresses

Primary practice location

449 Kapahulu Ave Ste 104
Honolulu, HI 96815-3850

Mailing address

449 Kapahulu Ave Ste 104
Honolulu, HI 96815-3850
Phone (808) 735-0007

Other practice location 1

44-127 Keaalau Pl
Kaneohe, HI 96744-2531
Phone (808) 971-1822

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230823000688 HI Practitioner - Family Practice 1153656830 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Queens University Medical GroupGroup PAC ID 2466831557, 614 clinicians

Practice addresses (Care Compare)

1215 Hunakai St
Honolulu, HI 96816-4661
Phone (808) 691-8200

1380 Lusitana St
Honolulu, HI 96813-2448

400 Keawe St
Honolulu, HI 96813-5199
Phone (808) 735-0007

449 Kapahulu Ave
Suite 104
Honolulu, HI 96815-3850
Phone (808) 735-0007

91 -6390 Kapolei Pkwy
Ewa Beach, HI 96706-6380
Phone (808) 735-0007

98-199 Kamehameha Hwy
BLDG F
Aiea, HI 96701-4821
Phone (808) 735-0007

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-23502HIMDFamily Medicine Physician
21469NVMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Queens University Medical Group CurrentSince Aug 5, 2023 Accepting new patients
Ucxtra Umbrella, LLC PastSince Dec 27, 2021 Accepting new patients

Locations

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

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

449 Kapahulu Ave
Ste 104
Honolulu, HI 96815
Phone (800) 735-0007

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1559779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1679132344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "449 KAPAHULU AVE STE 104",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968153850",
            "telephone_number": "808-735-0007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "449 KAPAHULU AVE STE 104",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968153850",
            "telephone_number": "808-735-0007"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "44-127 Keaalau Pl",
            "address_purpose": "LOCATION",
            "city": "Kaneohe",
            "state": "HI",
            "postal_code": "967442531",
            "country_code": "US",
            "telephone_number": "808-971-1822",
            "fax_number": "702-964-1185",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEENE",
        "first_name": "TIMOTHY",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-06",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "21469",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NV",
            "license": "21469",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NV",
            "license": "21469",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "HI",
            "license": "MD-23502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.