NPIMap

Individual provider Active NPI

John V. Mickey, M.D.

  • Internal Medicine Physician
  • Honolulu, HI
National Provider Identifier
1790875888
Registry record updated Mar 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD-3556 Issued in HI
Practice address
888 S King St
Honolulu, HI 96813-3009
Phone
(808) 522-4000
Fax
(808) 522-4515
NPI assigned
Oct 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2012

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 MD-3556 HI Primary

Addresses

Primary practice location

888 S King St
Honolulu, HI 96813-3009

Mailing address

888 S King St
Straub Department of Internal Medicine
Honolulu, HI 96813-3097
Phone (808) 522-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110110000612 HI Practitioner - Internal Medicine 9931090099 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Duke University School of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Straub Clinic and HospitalGroup PAC ID 6305759754, 420 clinicians

Practice addresses (Care Compare)

888 S King St
Honolulu, HI 96813-3097
Phone (808) 522-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-3556HIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Straub Clinic & Hospital CurrentSince Dec 23, 2001 Accepting new patients
Straub Clinic & Hospital CurrentSince Dec 23, 2001 Accepting new patients
Straub Clinic & Hospital Past Accepting new patients

Locations

888 S King St
Honolulu, HI 96813
Phone (808) 522-4000

Organizations & group practices 3

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 8

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331856000000",
    "number": "1790875888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "888 S KING ST",
            "address_2": "STRAUB DEPARTMENT OF INTERNAL MEDICINE",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968133097",
            "telephone_number": "808-522-4000",
            "fax_number": "808-522-4515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 S KING ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968133009",
            "telephone_number": "808-522-4000",
            "fax_number": "808-522-4515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKEY",
        "first_name": "JOHN",
        "middle_name": "V.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2012-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "MD-3556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.