Liane Junko Watanabe, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

PO-196 Issued in HI

Practice address

1245 Kuala St Ste 102a
Pearl City, HI 96782-3900

Phone

(808) 726-2161

Fax

(808) 726-2163

NPI assigned

Mar 22, 2011

Last updated

Jan 31, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Liane Junko Watanabe-Lin Former name

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hawaii Podiatry Inc

  • Foot & Ankle Surgery Podiatrist
  • Pearl City, HI
  • NPI 1235549056
  Authorized official Same address or phone
• Aloha Family Footcare LLC

  • Podiatrist
  • Kahului, HI
  • NPI 1366690240
  NPD (past)

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

{
    "created_epoch": "1300752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1750680369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 KUALA ST STE 102A",
            "city": "PEARL CITY",
            "state": "HI",
            "postal_code": "967823900",
            "telephone_number": "808-726-2161",
            "fax_number": "808-726-2163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 KUALA ST STE 102A",
            "city": "PEARL CITY",
            "state": "HI",
            "postal_code": "967823900",
            "telephone_number": "808-726-2161",
            "fax_number": "808-726-2163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATANABE",
        "first_name": "LIANE",
        "middle_name": "JUNKO",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-22",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "HI",
            "license": "PO-196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "79310",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DPM",
            "identifier": "PO-196",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LIANE",
            "last_name": "WATANABE-LIN",
            "middle_name": "JUNKO",
            "credential": "DPM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Wal-Mart Stores, Inc (Vision Center 30-5274)
• Walk & Roll Physical Therapy LLC
• Walk & Roll Physical Therapy, LLC
• Walmart Inc. (Walmart Pharmacy 10-5274)
• Curt K Watanabe, D.P.T.
• Heather M Wawrzenski, O.D.
• Stephen Robert Way, SOIDC
• Wayne Suga, M.D.
• Emily Whitehouse, MS, CCC-SLP
• Felicia Williams-Rishty, RBT 16-20507

• Foot & Ankle Surgery Podiatrist in Pearl City, HI
• Providers in Pearl City, HI by specialty
• Foot & Ankle Surgery Podiatrist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.