Eric S. Mizuba, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC007380L Issued in PA

Practice address

65-1206 Mamalahoa Hwy Ste 3-12
Kamuela, HI 96743-7303

Phone

(814) 490-3104

Fax

(814) 833-9355

NPI assigned

Apr 3, 2006

Last updated

Mar 21, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in HI

Enrollment records 1

Specialty

Chiropractic

Education

Other, 1998

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521590400000",
    "number": "1881656254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65-1206 MAMALAHOA HWY STE 3-12",
            "city": "KAMUELA",
            "state": "HI",
            "postal_code": "967437303",
            "telephone_number": "814-490-3104",
            "fax_number": "814-833-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65-1206 MAMALAHOA HWY STE 3-12",
            "city": "KAMUELA",
            "state": "HI",
            "postal_code": "967437303",
            "telephone_number": "814-490-3104",
            "fax_number": "814-833-9355"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4125 W Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Erie",
            "state": "PA",
            "postal_code": "165061721",
            "country_code": "US",
            "telephone_number": "814-833-9355",
            "fax_number": "814-833-9355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIZUBA",
        "first_name": "ERIC",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2018-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC007380L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001786492/0002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Kamuela, HI
• Providers in Kamuela, HI by specialty
• Chiropractor in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.