Koji Iizuka, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

16581 Issued in HI

Practice address

928 Nuuanu Ave Lowr Level
Honolulu, HI 96817-5193

Phone

(808) 728-6618

Fax

(808) 215-4255

NPI assigned

Apr 20, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in HI, GU2 enrollments

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 2

Specialty

Psychiatry

Education

Loma Linda University School of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: koji.iizuka.1@31775.direct.athenahealth.com

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.

• General Conference Corp of Sda

  • Clinic/Center
  • Tamuning, GU
  • NPI 1275586877
  Medicare reassignment NPD

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

{
    "created_epoch": "1271721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1811213523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ATTN: ABS",
            "address_2": "P.O. BOX 60599",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "96706",
            "telephone_number": "808-664-1104",
            "fax_number": "866-592-3149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 NUUANU AVE LOWR LEVEL",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968175193",
            "telephone_number": "808-728-6618",
            "fax_number": "808-215-4255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IIZUKA",
        "first_name": "KOJI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-20",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GU",
            "license": "EMTL-2020-023",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "HI",
            "license": "16581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caleb Ken Iida-Laurent
• Jessica C Iida, OD
• Kathy Iida, O.D.
• Takeshi Iimura, M.D.
• Julieann Iinuma, M.D.
• Lisa Ijiri
• Ike Loa Therapeutic Services, Inc
• Alvin K Ikeda, M.D.
• Jamie Marie Ikeda, MS, CCC-SLP
• Jan Ikeda

• Psychiatry Physician in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Psychiatry Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.