Susannah Kerr Mistr, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

MD 15669 Issued in HI

Practice address

68-1845 Waikoloa Rd
Suite 218
Waikoloa, HI 96738-5584

Phone

(808) 883-3767

NPI assigned

Jun 5, 2007

Last updated

Mar 2, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• 10 Eye Center

  • Optometrist
  • Kailua Kona, HI
  • NPI 1699375188
  NPD (past)

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425254400000",
    "number": "1811199417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 383147",
            "city": "WAIKOLOA",
            "state": "HI",
            "postal_code": "967383147",
            "telephone_number": "808-883-3767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68-1845 WAIKOLOA RD",
            "address_2": "SUITE 218",
            "city": "WAIKOLOA",
            "state": "HI",
            "postal_code": "967385584",
            "telephone_number": "808-883-3767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISTR",
        "first_name": "SUSANNAH",
        "middle_name": "KERR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-05",
        "last_updated": "2015-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "HI",
            "license": "MD 15669",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR  MEDICARE",
            "identifier": "P00926555",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "645070",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cara Larsen
• Mark Litzinger
• Monica Litzinger
• Lokahi Treatment Centers
• Mana Physical Therapy Inc.
• Nan Kuli Kai Pharmacy Inc (Waikoloa Pharmacy)
• Nina M Nemetz, OD
• Khoa Dang Nguyen, OD
• North Hawaii Mental Health, LLC
• One Holistic Place

• Ophthalmology Physician in Waikoloa, HI
• Providers in Waikoloa, HI by specialty
• Ophthalmology Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.