Jeffrey M Cryan, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

MD-20653 Issued in HI

Practice address

221 Mahalani St
Wailuku, HI 96793-2526

Phone

(808) 442-5700

NPI assigned

May 11, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 9

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Hilo Benioff Medical Center

  • General Acute Care Hospital
  • Hilo, HI
  • NPI 1962584060

  HI

  Medicare reassignment NPD
• Maui Health System a Kaiser Foundation Hospitals LLC

  • General Acute Care Hospital
  • Wailuku, HI
  • NPI 1013379460

  HI

  Medicare reassignment NPD
• Hilo Benioff Medical Center

  • Anesthesiology Physician
  • Hilo, HI
  • NPI 1235981614
  NPD
• Maui Health System a Kaiser Foundation Hospitals LLC

  • Specialist
  • Wailuku, HI
  • NPI 1669834016
  NPD

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666569600000",
    "number": "1831149566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 117",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967930117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 MAHALANI ST",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967932526",
            "telephone_number": "808-442-5700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 45th St",
            "address_purpose": "LOCATION",
            "city": "Mangonia Park",
            "state": "FL",
            "postal_code": "334072413",
            "country_code": "US",
            "telephone_number": "561-844-6300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1190 Waianuenue Ave",
            "address_purpose": "LOCATION",
            "city": "Hilo",
            "state": "HI",
            "postal_code": "967202089",
            "country_code": "US",
            "telephone_number": "808-932-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRYAN",
        "first_name": "JEFFREY",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME95163",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "MA45913",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "HI",
            "license": "MD-20653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "812390",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMGP",
            "identifier": "0263605",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0263605",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRM",
            "identifier": "020016583",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OX",
            "identifier": "P831178",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "0100238000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4301156",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "4511",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "F02707",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca L Cronk
• Kerry G Crosby, FNP
• David S. Crow, M.D.
• Cierra Crowe, M.A., CCC-SLP
• Grace Crozier, LMT
• Heather Leigh Culpepper, P.T.
• Victoria Anne D'Auteuil, PT
• Ross M Dagley, NMT
• Dorothy M Dahl, LMT
• Cyril A. Dalmon, M.D.

• All providers in Wailuku, HI
• Gastroenterology Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.