Active NPI
Dennis W Boulware, MD
- Rheumatology Physician
- Honolulu, HI
National Provider Identifier
1689621674
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rheumatology Physician
- License
- MD-11274
- Practice address
- 2828 Paa St
Honolulu, HI 96819-4430 - Phone
- (808) 432-5770
- NPI assigned
- May 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rheumatology Physician | 207RR0500X | 16747 | AL | |
| Rheumatology Physician | 207RR0500X | MD-11274 | HI | Primary |
Addresses
Primary practice location
2828 Paa St
Honolulu, HI 96819-4430
Mailing address
2828 Paa St
Honolulu, HI 96819-4430
Phone (808) 432-5770
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000084618 | Medicaid | AL | |
| 5081 | Other | AL | HEALTHSPRING |
| 660001272 | Other | AL | RAILROAD MEDICARE |
| 0000267930 | Other | HI | HMSA BILLING NUMBER |
| 000084618 | Other | AL | BLUE CROSS |
| 597403-01 | Medicaid | HI | |
| B62186 | Other | AL | VIVA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16747 | AL | MD | Rheumatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285286400000",
"number": "1689621674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2828 PAA ST",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968194430",
"telephone_number": "808-432-5770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2828 PAA ST",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968194430",
"telephone_number": "808-432-5770"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOULWARE",
"first_name": "DENNIS",
"middle_name": "W",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-27",
"last_updated": "2010-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "AL",
"license": "16747",
"primary": false
},
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "HI",
"license": "MD-11274",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000084618",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHSPRING",
"identifier": "5081",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "660001272",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HMSA BILLING NUMBER",
"identifier": "0000267930",
"state": "HI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "000084618",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "597403-01",
"state": "HI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VIVA",
"identifier": "B62186",
"state": "AL"
}
],
"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 Sep 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.