Individual provider Active NPI

Howard Neudorf

  • Family Medicine Physician
  • Waipahu, HI
National Provider Identifier
1740267145
Registry record updated May 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD - 7199 Issued in HI
Practice address
94-239 Waipahu Depot St
106
Waipahu, HI 96797-3056
Phone
(808) 677-1912
Fax
(866) 610-1585
NPI assigned
Dec 27, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD - 7199 HI Primary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 7199 HI

Addresses

Primary practice location

94-239 Waipahu Depot St
106
Waipahu, HI 96797-3056

Mailing address

94-830 Lelepua St
A
Waipahu, HI 96797-5124
Phone (808) 677-1912

Other identifiers 1

IdentifierTypeStateIssuer
00915101MedicaidHI

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
I20051011001176 HI Practitioner - Family Practice 8022033786 Practice locations: Waipahu, HI

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

94 -239 Waipahu Depot St
Suite 106
Waipahu, HI 96797-3056

94 -239 Waipahu Depot St
Suite 106
Waipahu, HI 96797-3087
Phone (808) 677-1912

94 -830 Lelepua St
A
Waipahu, HI 96797-5124

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD - 7199HIMDFamily Medicine Physician
7199HIMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Howard F. Neudorf, M.D. Past Accepting new patients

Organizations & group practices 1

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 1

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": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367884800000",
    "number": "1740267145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94-830 LELEPUA ST",
            "address_2": "A",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967975124",
            "telephone_number": "808-677-1912",
            "fax_number": "866-610-1585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94-239 WAIPAHU DEPOT ST",
            "address_2": "106",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967973056",
            "telephone_number": "808-677-1912",
            "fax_number": "866-610-1585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEUDORF",
        "first_name": "HOWARD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-27",
        "last_updated": "2013-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "HI",
            "license": "MD - 7199",
            "primary": true
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "HI",
            "license": "7199",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00915101",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waipahu, HI

Sources for this page

Verify at the official NPI Registry.