Individual provider Active NPI

Panupong Jiamsripong, M.D.

  • Cardiovascular Disease Physician
  • Aiea, HI
National Provider Identifier
1801186200
Registry record updated Jun 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
17399 Issued in HI
Practice address
98-1079 Moanalua Rd
Aiea, HI 96701-4713
Phone
(808) 486-6000
NPI assigned
Apr 19, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 17399 HI Primary

Addresses

Primary practice location

98-1079 Moanalua Rd
Aiea, HI 96701-4713

Mailing address

98-1079 Moanalua Rd
Aiea, HI 96701-4713
Phone (808) 486-6000

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
I20201005002716 HI Practitioner - Cardiovascular Disease (Cardiology) 7911127337 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pali Momi Medical CenterGroup PAC ID 6406746916, 90 clinicians

Practice addresses (Care Compare)

98 -1079 Moanalua Rd
Aiea, HI 96701-4713
Phone (808) 486-6000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.35 of 100Reported as group
Quality
67.49
Promoting interoperability
100
Improvement activities
40
Cost
77

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17399HIMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pali Momi Medical Center CurrentSince Aug 24, 2020 Accepting new patients
Pali Momi Medical Center CurrentSince Aug 24, 2020 Accepting new patients

Locations

98-1079 Moanalua Rd
Ste 680
Aiea, HI 96701
Phone (808) 485-4250

98-1079 Moanalua Rd
Aiea, HI 96701
Phone (808) 485-4301

98-1079 Moanalua Rd
Ste 590
Aiea, HI 96701
Phone (808) 485-4250

Organizations & group practices 2

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 3

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": "1303171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592524800000",
    "number": "1801186200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98-1079 MOANALUA RD",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967014713",
            "telephone_number": "808-486-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98-1079 MOANALUA RD",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967014713",
            "telephone_number": "808-486-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIAMSRIPONG",
        "first_name": "PANUPONG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-19",
        "last_updated": "2020-06-19",
        "certification_date": "2020-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "HI",
            "license": "17399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiea, HI

Sources for this page

Verify at the official NPI Registry.