Individual provider Active NPI

Marc Jyun Suenaga, AGACNP

  • Acute Care Nurse Practitioner
  • Honolulu, HI
National Provider Identifier
1891388781
Registry record updated Feb 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
APRN-3142 Issued in HI
Practice address
1301 Punchbowl St
Honolulu, HI 96813-2402
Phone
(808) 691-7152
NPI assigned
Feb 11, 2021
Last updated
Feb 11, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X APRN-3142 HI Primary

Addresses

Primary practice location

1301 Punchbowl St
Honolulu, HI 96813-2402

Mailing address

1301 Punchbowl St
Honolulu, HI 96813-2402
Phone (808) 691-7152

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210407002703 HI Practitioner - Nurse Practitioner 6002223153 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
97.05 of 100Reported as apm
Quality
89.81
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN-3142HIMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Queens Medical Center CurrentSince Apr 12, 2021 Accepting new patients
The Queen's Medical Center CurrentSince Apr 12, 2021 Accepting new patients
The Queen's Medical Center Current Accepting new patients
Queens University Medical Group CurrentSince Apr 22, 2022 Accepting new patients

Locations

1301 Punchbowl St
Honolulu, HI 96813
Phone (808) 538-9011

1380 Lusitana St
Ste 913
Honolulu, HI 96813
Phone (808) 691-8521

550 S Beretania St
Ste 404
Honolulu, HI 96813
Phone (808) 691-8897

Organizations & group practices 4

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": "1613001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613001600000",
    "number": "1891388781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 PUNCHBOWL ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132402",
            "telephone_number": "808-691-7152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 PUNCHBOWL ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132402",
            "telephone_number": "808-691-7152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUENAGA",
        "first_name": "MARC",
        "middle_name": "JYUN",
        "credential": "AGACNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-11",
        "last_updated": "2021-02-11",
        "certification_date": "2021-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "HI",
            "license": "APRN-3142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.