Individual provider Active NPI

George B Lisehora, M.D.

  • Specialist
  • Honolulu, HI
National Provider Identifier
1881621985
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD5848 Issued in HI
Practice address
1380 Lusitana St
Suite 614
Honolulu, HI 96813-2449
Phone
(808) 524-1856
Fax
(808) 524-8331
NPI assigned
Jun 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD5848 HI Primary

Addresses

Primary practice location

1380 Lusitana St
Suite 614
Honolulu, HI 96813-2449

Mailing address

1380 Lusitana St
Suite 614
Honolulu, HI 96813-2449
Phone (808) 524-1856

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
I20100817000376 HI Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 6002940764 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)Also: General Surgery
Education
Jefferson Medical College of Thomas Jefferson University, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Colorectal AssociatesGroup PAC ID 6103718341, 2 clinicians

Practice addresses (Care Compare)

1380 Lusitana St
Suite 614
Honolulu, HI 96813-2442
Phone (808) 524-1856

Hospital & facility affiliations

  • The Queens Medical Center Hospital, Honolulu, HI, CCN 120001

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy86
Upper gastrointestinal (GI) endoscopy for acid reflux18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD5848HIMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Colorectal Associates Specialist CurrentSince Oct 1, 1996 Accepting new patients

Locations

1401 S Beretania St
Ste 200
Honolulu, HI 96814
Phone (808) 312-6700

1380 Lusitana St
Ste 614
Honolulu, HI 96813
Phone (808) 524-1856

Interoperability endpoints

  • Direct secure messaging: george.lisehora@38062951497732.direct.elationemr.com

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881621985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 LUSITANA ST",
            "address_2": "SUITE 614",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132449",
            "telephone_number": "808-524-1856",
            "fax_number": "808-524-8331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 LUSITANA ST",
            "address_2": "SUITE 614",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132449",
            "telephone_number": "808-524-1856",
            "fax_number": "808-524-8331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISEHORA",
        "first_name": "GEORGE",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "HI",
            "license": "MD5848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.