Individual provider Active NPI

Gerald H Watanabe, M.D.

  • Internal Medicine Physician
  • Honolulu, HI
National Provider Identifier
1770660581
Registry record updated Dec 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD7651 Issued in HI
Practice address
321 N Kuakini St
Suite 802
Honolulu, HI 96817-2362
Phone
(808) 529-8801
Fax
(808) 529-8803
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD7651 HI Primary

Addresses

Primary practice location

321 N Kuakini St
Suite 802
Honolulu, HI 96817-2362

Mailing address

321 N Kuakini St
Suite 802
Honolulu, HI 96817-2362
Phone (808) 529-8801

Other identifiers 1

IdentifierTypeStateIssuer
048553-01MedicaidHI

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
I20070226000045 HI Practitioner - Internal Medicine 7719089572 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Saint Louis University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

321 N Kuakini St
Suite 802
Honolulu, HI 96817-2362
Phone (808) 529-8801

Hospital & facility affiliations

  • Kuakini Medical Center Hospital, Honolulu, HI, CCN 120007
  • The Queens Medical Center Hospital, Honolulu, HI, CCN 120001
  • Kapiolani Medical Center for Women & Children Hospital, Honolulu, HI, CCN 123300
  • Adventist Health Castle Hospital, Kailua, HI, CCN 120006
  • 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
MD7651HIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gerald H Watanabe MD LTD CurrentSince Dec 10, 2015 Accepting new patients

Locations

321 N Kuakini St
Ste 802
Honolulu, HI 96817
Phone (808) 529-8801

Interoperability endpoints

  • Direct secure messaging: gerald.watanabe.1@13635.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/13635/brand/1/csg/1/fhir/r4

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 5

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451520000000",
    "number": "1770660581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 N KUAKINI ST",
            "address_2": "SUITE 802",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968172362",
            "telephone_number": "808-529-8801",
            "fax_number": "808-529-8803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 N KUAKINI ST",
            "address_2": "SUITE 802",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968172362",
            "telephone_number": "808-529-8801",
            "fax_number": "808-529-8803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATANABE",
        "first_name": "GERALD",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2015-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "MD7651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "048553-01",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.