Individual provider Active NPI

Mae Satsuki Ikeda Kyono, M.D.

  • Pediatrics Physician
  • Honolulu, HI
National Provider Identifier
1720136906
Registry record updated Mar 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
6975 Issued in HI
Practice address
1329 Lusitana St
Suite 701
Honolulu, HI 96813-2431
Phone
(808) 548-7337
Fax
(808) 548-7330
NPI assigned
Jan 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 6975 HI Primary

Addresses

Primary practice location

1329 Lusitana St
Suite 701
Honolulu, HI 96813-2431

Mailing address

1329 Lusitana St
Suite 701
Honolulu, HI 96813-2431
Phone (808) 548-7337

Other identifiers 1

IdentifierTypeStateIssuer
060620MedicaidHI

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
I20110919000507 HI Practitioner - Pediatric Medicine 1254502503 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6975HIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kapiolani Medical Specialists CurrentSince Aug 20, 2011 Accepting new patients
Kapiolani Medical Center for Women & Children Past Accepting new patients

Locations

1319 Punahou St
Honolulu, HI 96826
Phone (808) 485-4300

1319 Punahou St
#902
Honolulu, HI 96826

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.

NPI Registry JSON

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

{
    "created_epoch": "1168041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205712000000",
    "number": "1720136906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1329 LUSITANA ST",
            "address_2": "SUITE 701",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132431",
            "telephone_number": "808-548-7337",
            "fax_number": "808-548-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1329 LUSITANA ST",
            "address_2": "SUITE 701",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132431",
            "telephone_number": "808-548-7337",
            "fax_number": "808-548-7330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KYONO",
        "first_name": "MAE",
        "middle_name": "SATSUKI IKEDA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-06",
        "last_updated": "2008-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "HI",
            "license": "6975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060620",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.