Organization Active NPI

Family Eye Care Associates-Kapolei, LLC.

  • Optometrist
  • Kapolei, HI
National Provider Identifier
1700011996
Registry record updated Feb 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
572 Issued in HI
Legal business name
FAMILY EYE CARE ASSOCIATES-KAPOLEI, LLC.
Practice address
1001 Kamokila Blvd # 108
James Campbell BLDG.
Kapolei, HI 96707-2014
Phone
(808) 674-0085
Fax
(808) 674-8785
NPI assigned
May 18, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2010

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

Authorized official

Name
Dr. Todd Kyle Nakagawa, O.D.NPI 1679598619
Title
Optometrist/Owner
Phone
(808) 674-0085

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 572 HI Primary

Addresses

Primary practice location

1001 Kamokila Blvd # 108
James Campbell BLDG.
Kapolei, HI 96707-2014

Mailing address

1001 Kamokila Blvd # 108
James Campbell BLDG.
Kapolei, HI 96707-2014
Phone (808) 674-0085

Other identifiers 1

IdentifierTypeStateIssuer
0000238154MedicaidHI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091006000270 HI Part B Supplier - Clinic/Group Practice 0648316711 Receives reassigned benefits from 1 practitioner
Practice locations: Kapolei, HI

National Provider Directory

National Provider Directory

Locations

1001 Kamokila Blvd
Ste 108
Kapolei, HI 96707
Phone (808) 674-0085

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1242604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265155200000",
    "number": "1700011996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 KAMOKILA BLVD # 108",
            "address_2": "JAMES CAMPBELL BLDG.",
            "city": "KAPOLEI",
            "state": "HI",
            "postal_code": "967072014",
            "telephone_number": "808-674-0085",
            "fax_number": "808-674-8785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 KAMOKILA BLVD # 108",
            "address_2": "JAMES CAMPBELL BLDG.",
            "city": "KAPOLEI",
            "state": "HI",
            "postal_code": "967072014",
            "telephone_number": "808-674-0085",
            "fax_number": "808-674-8785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY EYE CARE ASSOCIATES-KAPOLEI, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-18",
        "last_updated": "2010-02-03",
        "status": "A",
        "authorized_official_last_name": "NAKAGAWA",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "KYLE",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "808-674-0085",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "HI",
            "license": "572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000238154",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kapolei, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.