Individual provider Active NPI

Wayne Susumu Matsuyama, O.D.

  • Optometrist
  • Aiea, HI
National Provider Identifier
1750355764
Registry record updated Sep 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
130 Issued in HI
Practice address
98-150 Kaonohi St
Suite B211
Aiea, HI 96701-5047
Phone
(808) 486-3937
Fax
(808) 486-3386
NPI assigned
Feb 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 130 HI Primary

Addresses

Primary practice location

98-150 Kaonohi St
Suite B211
Aiea, HI 96701-5047

Mailing address

98-150 Kaonohi St
Suite B211
Aiea, HI 96701-5047
Phone (808) 486-3937

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040408001218 HI Practitioner - Optometry 0547156788 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Matsuyamas O D IncGroup PAC ID 2365338597, 2 clinicians

Practice addresses (Care Compare)

98 -150 Kaonohi St
Aiea, HI 96701-5022
Phone (808) 486-3937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
130HIMDAmbulatory Care Registered Nurse

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.

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379635200000",
    "number": "1750355764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98-150 KAONOHI ST",
            "address_2": "SUITE B211",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967015047",
            "telephone_number": "808-486-3937",
            "fax_number": "808-486-3386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98-150 KAONOHI ST",
            "address_2": "SUITE B211",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967015047",
            "telephone_number": "808-486-3937",
            "fax_number": "808-486-3386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATSUYAMA",
        "first_name": "WAYNE",
        "middle_name": "SUSUMU",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2013-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "HI",
            "license": "130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiea, HI

Sources for this page

Verify at the official NPI Registry.