Deryll U Ambrocio MD Incorporated

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

License

MD-15066 Issued in HI

Legal business name

DERYLL U AMBROCIO MD INCORPORATED

Practice address

1329 Lusitana St
Suite 804
Honolulu, HI 96813-2429

Phone

(808) 531-7111

Fax

(808) 528-5507

NPI assigned

May 12, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Deryll Ulep Ambrocio, MDNPI 1730301219

Title

President

Phone

(808) 531-7111

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in HI

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Deryll U Ambrocio, MD

  • Rheumatology Physician
  • Honolulu, HI
  • NPI 1730301219
  Medicare reassignment NPD Authorized official
• Glenda Malana, MD

  • Internal Medicine Physician
  • Ewa Beach, HI
  • NPI 1639103070
  NPD (past)

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

{
    "created_epoch": "1242086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282867200000",
    "number": "1679707103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1329 LUSITANA ST",
            "address_2": "SUITE 804",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132429",
            "telephone_number": "808-531-7111",
            "fax_number": "808-528-5507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1329 LUSITANA ST",
            "address_2": "SUITE 804",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132429",
            "telephone_number": "808-531-7111",
            "fax_number": "808-528-5507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERYLL U AMBROCIO MD INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-12",
        "last_updated": "2010-08-27",
        "status": "A",
        "authorized_official_last_name": "AMBROCIO",
        "authorized_official_first_name": "DERYLL",
        "authorized_official_middle_name": "ULEP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "808-531-7111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "HI",
            "license": "MD-15066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dermspace Hawaii LLC
• Olivia Derrek
• Joda P. Derrickson, PH.D, RD, ACSM EP-C
• Kainani M Derrickson, LCSW
• Konane M Deryke, OTR
• David C. Des Jarlais, MD
• Deza-Rae Desa
• Tushar K Desai, MD
• Gautam Anil Deshpande, M.D.
• Heidi Desimone, APRN

• Rheumatology Physician in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Rheumatology Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.