Individual provider Active NPI

Louie Mar Alviz Gangcuangco, MD, MSC

  • Public Health & General Preventive Medicine Physician
  • Honolulu, HI
National Provider Identifier
1891100319
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X
License
MD-22727-0 Issued in HI
Practice address
651 Ilalo St
Honolulu, HI 96813-5525
Phone
(808) 692-1357
NPI assigned
Jun 23, 2014
Last updated
Jul 7, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Public Health & General Preventive Medicine Physician 2083P0901X MD-22727-0 HI Primary

Addresses

Primary practice location

651 Ilalo St
Honolulu, HI 96813-5525

Mailing address

651 Ilalo St
Honolulu, HI 96813-5525
Phone (808) 692-1357

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
I20220802002387 HI Practitioner - Preventive Medicine 9234511668 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Preventive Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Waikiki HealthGroup PAC ID 9335058536, 27 clinicians

Practice addresses (Care Compare)

277 Ohua Ave
Honolulu, HI 96815-6612
Phone (808) 791-9335

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-22727-0HIMDPublic Health & General Preventive Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Waikiki Health CurrentSince Jul 14, 2024 Accepting new patients
Waikiki Health CurrentSince Jul 14, 2024 Accepting new patients

Locations

277 Ohua Ave
Honolulu, HI 96815
Phone (808) 791-9355

845 22nd Ave
#5
Honolulu, HI 96816
Phone (808) 734-2034

Interoperability endpoints

  • Direct secure messaging: louie.gangcuangco.1@15051.direct.athenahealth.com

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.

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": "1403481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1891100319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "651 ILALO ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968135525",
            "telephone_number": "808-692-1357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 ILALO ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968135525",
            "telephone_number": "808-692-1357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANGCUANGCO",
        "first_name": "LOUIE MAR",
        "middle_name": "ALVIZ",
        "name_prefix": "Dr.",
        "credential": "MD, MSC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-23",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "HI",
            "license": "MD-22727-0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.