Individual provider Active NPI

Michael J Shea, MD

  • Pulmonary Disease Physician
  • Wailuku, HI
National Provider Identifier
1689666471
Registry record updated Jul 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
214900 Issued in NY
Practice address
221 Mahalani St
Wailuku, HI 96793-2526
Phone
(808) 442-5700
Fax
(808) 442-5701
NPI assigned
Aug 17, 2005
Last updated
Jul 1, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 214900 NY Primary

Addresses

Primary practice location

221 Mahalani St
Wailuku, HI 96793-2526

Mailing address

85 Maui Lani Pkwy
Wailuku, HI 96793-2416
Phone (808) 442-5700

Other identifiers 1

IdentifierTypeStateIssuer
02394223MedicaidNY

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
I20130328000188 HI Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 4789620204 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
New York Medical College, 1998
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

221 Mahalani St
Wailuku, HI 96793-2526
Phone (808) 244-9056

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Maui Health System a Kaiser Foundation Hospitals LLC Current Accepting new patients
Maui Health System a Kaiser Foundation Hospitals LLC CurrentSince May 31, 2017 Accepting new patients
Maui Health System a Kaiser Foundation Hospitals LLC CurrentSince May 31, 2017 Accepting new patients
Hawaii Permanente Medical Group Inc CurrentSince Jul 1, 2016 Accepting new patients
Hospitalist Medicine Physicians of Albany County, PLLC Past Accepting new patients
Maui Chest Medicine, Inc Pulmonary Disease PastSince Mar 30, 2016 Accepting new patients

Locations

3288 Moanalua Rd
Honolulu, HI 96819
Phone (808) 432-8000

711 Kapiolani Blvd
Honolulu, HI 96813
Phone (808) 432-5312

221 Mahalani St
Wailuku, HI 96793
Phone (808) 242-2290

85 Maui Lani Pkwy
Wailuku, HI 96793
Phone (808) 442-5700

Organizations & group practices 6

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": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467331200000",
    "number": "1689666471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 MAUI LANI PKWY",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967932416",
            "telephone_number": "808-442-5700",
            "fax_number": "808-442-5701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 MAHALANI ST",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967932526",
            "telephone_number": "808-442-5700",
            "fax_number": "808-442-5701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEA",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-17",
        "last_updated": "2016-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NY",
            "license": "214900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02394223",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wailuku, HI

Sources for this page

Verify at the official NPI Registry.