Individual provider Active NPI

Marc R Miyasaki, MD

  • Internal Medicine Physician
  • Honolulu, HI
National Provider Identifier
1760644389
Registry record updated Feb 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD14301 Issued in HI
Practice address
550 S Beretania St
Suite 605
Honolulu, HI 96813-2414
Phone
(808) 548-2100
NPI assigned
Jun 25, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD14301 HI Primary
Pediatrics Physician 208000000X MD14301 HI

Addresses

Primary practice location

550 S Beretania St
Suite 605
Honolulu, HI 96813-2414

Mailing address

550 S Beretania St
Suite 605
Honolulu, HI 96813-2414

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
I20080624000358 HI Practitioner - Internal MedicinePractitioner - Pediatric Medicine 6204907967 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Hawaii John a. Burns School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

550 S Beretania St
Suite 605
Honolulu, HI 96813-2496
Phone (808) 548-2100

Hospital & facility affiliations

  • Careresource Hawaii Home health agency, Honolulu, HI, CCN 127013
  • The Queens Medical Center Hospital, Honolulu, HI, CCN 120001
  • Kapiolani Medical Center for Women & Children Hospital, Honolulu, HI, CCN 123300
  • Pali Momi Medical Center Hospital, Aiea, HI, CCN 120026

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD14301HIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marc R. Miyasaki M.D. Inc. Internal Medicine CurrentSince Mar 22, 2009 Accepting new patients

Locations

550 S Beretania St
Ste 605
Honolulu, HI 96813
Phone (808) 548-2100

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 4

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": "1214352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330473600000",
    "number": "1760644389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 S BERETANIA ST",
            "address_2": "SUITE 605",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 S BERETANIA ST",
            "address_2": "SUITE 605",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132414",
            "telephone_number": "808-548-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIYASAKI",
        "first_name": "MARC",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-25",
        "last_updated": "2012-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "MD14301",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "HI",
            "license": "MD14301",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.