Individual provider Active NPI

Terri T. Tanaka, M.D.

  • Pediatrics Physician
  • Mililani, HI
National Provider Identifier
1861580649
Registry record updated Sep 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD-7509 Issued in HI
Practice address
95-1249 Meheula Pkwy
Unit 187
Mililani, HI 96789-1779
Phone
(808) 625-6444
Fax
(808) 623-2552
NPI assigned
Oct 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD-7509 HI Primary

Addresses

Primary practice location

95-1249 Meheula Pkwy
Unit 187
Mililani, HI 96789-1779

Mailing address

95-1249 Meheula Pkwy
Unit 187
Mililani, HI 96789-1779
Phone (808) 625-6444

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
I20100423000242 HI Practitioner - Pediatric Medicine 3072640002 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Straub Clinic & Hospital CurrentSince Mar 1, 2010 Accepting new patients
Straub Clinic & Hospital CurrentSince Mar 1, 2010 Accepting new patients

Locations

888 S King St
Honolulu, HI 96813
Phone (808) 522-4000

95-1249 Meheula Pkwy
Ste 187
Mililani, HI 96789
Phone (808) 282-6362

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.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285286400000",
    "number": "1861580649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95-1249 MEHEULA PKWY",
            "address_2": "UNIT 187",
            "city": "MILILANI",
            "state": "HI",
            "postal_code": "967891779",
            "telephone_number": "808-625-6444",
            "fax_number": "808-623-2552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95-1249 MEHEULA PKWY",
            "address_2": "UNIT 187",
            "city": "MILILANI",
            "state": "HI",
            "postal_code": "967891779",
            "telephone_number": "808-625-6444",
            "fax_number": "808-623-2552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANAKA",
        "first_name": "TERRI",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2010-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "HI",
            "license": "MD-7509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mililani, HI

Sources for this page

Verify at the official NPI Registry.