Individual provider Active NPI

Jhoanna D Mabutas, MD

  • Internal Medicine Physician
  • Honolulu, HI
National Provider Identifier
1841281599
Registry record updated May 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD 12226 Issued in HI
Practice address
2239 N School St
Honolulu, HI 96819-2539
Phone
(808) 791-9410
Fax
(808) 847-6051
NPI assigned
Nov 2, 2005
Last updated
May 17, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2013

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 12226 HI Primary

Addresses

Primary practice location

2239 N School St
Honolulu, HI 96819-2539

Mailing address

3938 Monterey PL
Honolulu, HI 96816-3922
Phone (808) 734-6167

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
I20070122000497 HI Practitioner - Internal MedicinePractitioner - Pediatric Medicine 7517968316 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD 12226HIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kokua Kalihi Valley Comprehensive Family Services CurrentSince Jul 19, 2008 Accepting new patients
Kokua Kalihi Valley Comprehensive Family Services CurrentSince Jul 19, 2008 Accepting new patients

Locations

1846 Gulick Ave
Honolulu, HI 96819
Phone (808) 791-9415

2239 N School St
Honolulu, HI 96819
Phone (808) 791-9400

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368748800000",
    "number": "1841281599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3938 MONTEREY PL",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968163922",
            "telephone_number": "808-734-6167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2239 N SCHOOL ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968192539",
            "telephone_number": "808-791-9410",
            "fax_number": "808-847-6051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MABUTAS",
        "first_name": "JHOANNA",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-02",
        "last_updated": "2013-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "MD 12226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.