Individual provider Active NPI

Katsuya Andrew Iizuka, M.D.

  • Family Medicine Physician
  • Kailua, HI
National Provider Identifier
1710040977
Registry record updated Mar 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD-16520 Issued in HI
Practice address
602 Kailua Rd
Suite 200
Kailua, HI 96734-2841
Phone
(808) 263-9100
Fax
(808) 263-9120
NPI assigned
Dec 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD-16520 HI Primary

Addresses

Primary practice location

602 Kailua Rd
Suite 200
Kailua, HI 96734-2841

Mailing address

602 Kailua Rd
Suite 200
Kailua, HI 96734-2841
Phone (808) 263-9100

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
I20120907000348 HI Practitioner - Family Practice 5294983748 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Loma Linda University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Straub Clinic and HospitalGroup PAC ID 6305759754, 420 clinicians

Practice addresses (Care Compare)

1001 Queen St
Suite 102
Honolulu, HI 96814-5243
Phone (808) 462-5200

888 S King St
Honolulu, HI 96813-3097
Phone (808) 522-4000

Hospital & facility affiliations

  • Bayada Home Health Care Home health agency, Honolulu, HI, CCN 127310
  • Adventist Health Home Care Services Home health agency, Kaneohe, HI, CCN 127017
  • Bristol Hospice - Hawaii, LLC Hospice, Honolulu, HI, CCN 121508
  • Islands Hospice Hospice, Honolulu, HI, CCN 121509
  • Straub Clinic and Hospital Hospital, Honolulu, HI, CCN 120022
  • Kapiolani Medical Center for Women & Children Hospital, Honolulu, HI, CCN 123300

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-16520HIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Straub Clinic & Hospital CurrentSince Sep 4, 2012 Accepting new patients
Straub Clinic & Hospital CurrentSince Sep 4, 2012 Accepting new patients
Straub Clinic & Hospital Past Accepting new patients

Locations

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

1001 Queen St
Ste 102
Honolulu, HI 96814
Phone (808) 462-5200

1946 Young St
Ste 320
Honolulu, HI 96826

602 Kailua Rd
Ste 200
Kailua, HI 96734
Phone (808) 263-9100

Interoperability endpoints

  • Direct secure messaging: katsuya.iizuka.1@19917.direct.athenahealth.com

Organizations & group practices 3

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": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490227200000",
    "number": "1710040977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 KAILUA RD",
            "address_2": "SUITE 200",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967342841",
            "telephone_number": "808-263-9100",
            "fax_number": "808-263-9120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 KAILUA RD",
            "address_2": "SUITE 200",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967342841",
            "telephone_number": "808-263-9100",
            "fax_number": "808-263-9120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IIZUKA",
        "first_name": "KATSUYA",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2017-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "HI",
            "license": "MD-16520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kailua, HI

Sources for this page

Verify at the official NPI Registry.