Individual provider Active NPI

Gilbert Masayaki Korenaga Jr.

  • Anesthesiology Physician
  • Honolulu, HI
National Provider Identifier
1700985850
Registry record updated Aug 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
05318 Issued in HI
Practice address
1301 Punchbowl St
Queen's Medical Center
Honolulu, HI 96813
Phone
(808) 538-9011
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 05318 HI Primary

Addresses

Primary practice location

1301 Punchbowl St
Queen's Medical Center
Honolulu, HI 96813

Mailing address

4348 Waialae Ave
Suite S-509
Honolulu, HI 96816-5767
Phone (808) 847-5385

Other identifiers 3

IdentifierTypeStateIssuer
E020346OtherHIHMSA
01895201MedicaidHI
15565770OtherHIWCOWCP

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
I20051010000498 HI Practitioner - AnesthesiologyPractitioner - Pain Management 4789609728 Practice locations: Aiea, HI

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
05318HIMDAnesthesiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282521600000",
    "number": "1700985850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4348 WAIALAE AVE",
            "address_2": "SUITE S-509",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968165767",
            "telephone_number": "808-847-5385",
            "fax_number": "808-373-2408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 PUNCHBOWL ST",
            "address_2": "QUEEN'S MEDICAL CENTER",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "96813",
            "telephone_number": "808-538-9011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORENAGA",
        "first_name": "GILBERT",
        "middle_name": "MASAYAKI",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2010-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "HI",
            "license": "05318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "E020346",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01895201",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WCOWCP",
            "identifier": "15565770",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.