Organization Active NPI

Lisa Nguyen MD LLC

  • Psychiatry Physician
  • Honolulu, HI
National Provider Identifier
1730537580
Registry record updated Jun 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD 18530 Issued in HI
Legal business name
LISA NGUYEN MD LLC
Practice address
1188 Bishop St Ste 1102
Honolulu, HI 96813-3304
Phone
(850) 888-8598
NPI assigned
Jun 1, 2016
Last updated
Jun 1, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2016

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

Authorized official

Name
Lisa NguyenNPI 1255621918
Title
MD
Phone
(850) 888-8598

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
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X MD 18530 HI Primary

Addresses

Primary practice location

1188 Bishop St Ste 1102
Honolulu, HI 96813-3304

Mailing address

1170 Nuuanu Ave Unit 38164
Honolulu, HI 96837-5648

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160922001520 HI Part B Supplier - Clinic/Group Practice 2466744792 Receives reassigned benefits from 1 practitioner
Practice locations: Honolulu, HI

National Provider Directory

National Provider Directory

Locations

1170 Nuuanu Ave
Unit 38164
Honolulu, HI 96837

1188 Bishop St
Ste 1102
Honolulu, HI 96813
Phone (808) 388-4969

3660 Waialae Ave
Ste 208
Honolulu, HI 96816
Phone (808) 256-6518

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1464739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464739200000",
    "number": "1730537580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1170 NUUANU AVE UNIT 38164",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968375648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1188 BISHOP ST STE 1102",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968133304",
            "telephone_number": "850-888-8598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA NGUYEN MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-01",
        "last_updated": "2016-06-01",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "850-888-8598"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "HI",
            "license": "MD 18530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2016; 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.