Queens University Medical Group

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

QUEENS UNIVERSITY MEDICAL GROUP

Practice address

1301 Punchbowl St
Honolulu, HI 96813-2402

Phone

(808) 691-1000

Fax

(808) 691-4646

NPI assigned

Feb 23, 2022

Last updated

Feb 27, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Traci K Kobayashi

Title

Treasurer

Phone

(808) 691-7795

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in HI, CA, WI, WA, ID, MA, NJ, DE, MD, PA, DC, MI, TX, LA, FL, UT, NY, OH, CT, AZ20 enrollments

Enrollment records 20

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Craigside Retirement Residence

  dba 15 Craigside

  • Nursing Facility/Intermediate Care Facility
  • Honolulu, HI
  • NPI 1659658664

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Practitioners 1,020

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Aaronoff, MD

  • Obstetrics & Gynecology Physician
  • Waipahu, HI
  • NPI 1013991132
  Medicare reassignment Care Compare group NPD
• Michael S Abdo, M.D.

  • Hospitalist Physician
  • Ewa Beach, HI
  • NPI 1730671116
  Medicare reassignment Care Compare group NPD
• Omar Abdul Fattah Abdul Ghani, M.B.B.S

  • Cardiovascular Disease Physician
  • Ewa Beach, HI
  • NPI 1982916839
  Medicare reassignment Care Compare group NPD
• Janette Knowlton Abramowitz

  • Psychiatry Physician
  • Honolulu, HI
  • NPI 1275952335
  Medicare reassignment Care Compare group NPD
• Jessica Jung Ackerman, FNP

  • Nurse Practitioner
  • Honolulu, HI
  • NPI 1003147687
  Medicare reassignment Care Compare group NPD
• Kyan Renie Agbayani

  • Internal Medicine Physician
  • Honolulu, HI
  • NPI 1083101323
  Medicare reassignment Care Compare group NPD
• Vanessa Mae Agsalda-Rosenbush, M.D.

  • Family Medicine Physician
  • Haleiwa, HI
  • NPI 1376613158
  Medicare reassignment Care Compare group NPD
• Gary W Ahn, MD

  • Sports Medicine (Internal Medicine) Physician
  • Honolulu, HI
  • NPI 1639260441
  Medicare reassignment Care Compare group NPD
• Maile Iwalani Alcos, APRN

  • Family Nurse Practitioner
  • Honolulu, HI
  • NPI 1225418759
  Medicare reassignment Care Compare group NPD
• Gloria Aldan, MD

  • Internal Medicine Physician
  • Honolulu, HI
  • NPI 1972990018
  Medicare reassignment Care Compare group NPD
• Mohammed Ali, MD

  • Hospitalist Physician
  • Honolulu, HI
  • NPI 1518529676
  Medicare reassignment Care Compare group NPD
• Masahisa Amano, M.D.

  • Family Medicine Physician
  • Haleiwa, HI
  • NPI 1881905388
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1645574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740614400000",
    "number": "1891441382",
    "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": "808-691-1000",
            "fax_number": "808-691-4646"
        },
        {
            "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": "808-691-1000",
            "fax_number": "808-691-4646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUEENS UNIVERSITY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-23",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A",
        "authorized_official_last_name": "KOBAYASHI",
        "authorized_official_first_name": "TRACI",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "808-691-7795"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Queens Development Corporation & Subsidiaries (Queens Pob III Pharmacy)
• Queens Development Corporation & Subsidiaries (Queens Pob III Pharmacy)
• Queens Geriatrics Population Health LLC
• Queens Medical Center
• Queens Medical Center
• Krychel Lynn Limo Quenga
• Josephine Paulita Quensell, M.D.
• Michelle Lokelani Karganilla Quensell
• Joseph Leon Quentin Sr., BS
• Shannele Quevedo

• Multi-Specialty Clinic/Center in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Multi-Specialty Clinic/Center in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.