NPIMap

Individual provider Active NPI

Venerando Seguritan, MD

  • Vascular & Interventional Radiology Physician
  • Kailua, HI
National Provider Identifier
1689654733
Registry record updated May 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
8892 Issued in HI
Practice address
640 Ulukahiki St
Kailua, HI 96734
Phone
(808) 263-5166
Fax
(808) 263-5167
NPI assigned
Jan 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X 8892 HI Primary

Addresses

Primary practice location

640 Ulukahiki St
Kailua, HI 96734

Mailing address

PO Box 16961
Portland, OR 97292-0961
Phone (808) 454-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI, OR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20041028000970 HI Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 7214914084 Reassigns benefits to 4 organizations
I20181214002640 OR Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 7214914084 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
New York Medical College, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Diagnostic Radiologists PCGroup PAC ID 4183510902, 16 clinicians

Practice addresses (Care Compare)

10123 SE Market St
Portland, OR 97216-2532
Phone (503) 251-6132

640 Ulukahiki St
Kailua, HI 96734-4454
Phone (808) 263-5142

Hospital & facility affiliations

  • Adventist Health Portland Hospital, Portland, OR, CCN 380060
  • Mid-Columbia Medical Center Hospital, The Dalles, OR, CCN 380001
  • Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009
  • Adventist Health Tillamook Hospital, Tillamook, OR, CCN 381317
  • Klickitat Valley Hospital Hospital, Goldendale, WA, CCN 501316

Merit-based Incentive Payment System (MIPS)

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8892HIMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Straub Clinic & Hospital CurrentSince Aug 13, 2019 Accepting new patients
Diagnostic Radiologists PC CurrentSince Jun 1, 2017 Accepting new patients
Queens University Medical Group CurrentSince Mar 16, 2024 Accepting new patients
Queens North Hawaii Community Hospital CurrentSince Mar 16, 2024 Accepting new patients
Straub Clinic & Hospital CurrentSince Aug 13, 2019 Accepting new patients
Pueblo Medical Imaging, LLC PastSince Dec 16, 1998 Accepting new patients
J Paul Wiesner & Associates Chartered PastSince Nov 3, 2019 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

888 S King St
Honolulu, HI 96813
Phone (808) 522-4000

640 Ulukahiki St
Kailua, HI 96734
Phone (808) 261-3326

67-1125 Mamalahoa Hwy
Kamuela, HI 96743
Phone (808) 881-4400

10123 SE Market St
Portland, OR 97216
Phone (503) 251-6355

1700 E 19th St
The Dalles, OR 97058
Phone (541) 296-7251

Interoperability endpoints

  • Direct secure messaging: vseguritan132470@direct.ohsu.edu

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493856000000",
    "number": "1689654733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16961",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972920961",
            "telephone_number": "808-454-5200",
            "fax_number": "808-454-5201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 ULUKAHIKI ST",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "96734",
            "telephone_number": "808-263-5166",
            "fax_number": "808-263-5167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEGURITAN",
        "first_name": "VENERANDO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2017-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "HI",
            "license": "8892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kailua, HI

Sources for this page

Verify at the official NPI Registry.