Individual provider Active NPI

Joseph Ryan Mateo Madamba, M.D.

  • Internal Medicine Physician
  • Honolulu, HI
National Provider Identifier
1902093305
Registry record updated Jul 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD15622 Issued in HI
Practice address
1712 Liliha St
Ste 203
Honolulu, HI 96817-5410
Phone
(808) 523-7955
NPI assigned
Sep 28, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD15622 HI Primary
Internal Medicine Physician 207R00000X A108723 CA

Addresses

Primary practice location

1712 Liliha St
Ste 203
Honolulu, HI 96817-5410

Mailing address

1712 Liliha St
Ste 203
Honolulu, HI 96817-5410
Phone (808) 523-7955

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
I20110221000265 HI Practitioner - Internal Medicine 0941481279 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Hawaii John a. Burns School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medical Office ForceGroup PAC ID 9335481951, 58 clinicians

Practice addresses (Care Compare)

1001 Bishop St
Suite 2685a
Honolulu, HI 96813-3404
Phone (706) 715-3105

1712 Liliha St
Suite 203
Honolulu, HI 96817-3100
Phone (808) 585-6094

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A108723CAMDInternal Medicine Physician
MD15622HIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Office Force Internal Medicine CurrentSince Oct 28, 2021 Accepting new patients
Joseph Ryan Madamba MD, Inc Internal Medicine CurrentSince Oct 8, 2010 Accepting new patients

Locations

2005 Prince Ave
Athens, GA 30606
Phone (706) 296-8632

1001 Bishop St
Ste 2685A
Honolulu, HI 96813
Phone (706) 715-3105

1712 Liliha St
Ste 203
Honolulu, HI 96817
Phone (808) 523-7955

Interoperability endpoints

  • Direct secure messaging: joseph.madamba@28103007731716.direct.elationemr.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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1190937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280016000000",
    "number": "1902093305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1712 LILIHA ST",
            "address_2": "STE 203",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968175410",
            "telephone_number": "808-523-7955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1712 LILIHA ST",
            "address_2": "STE 203",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968175410",
            "telephone_number": "808-523-7955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADAMBA",
        "first_name": "JOSEPH RYAN",
        "middle_name": "MATEO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-28",
        "last_updated": "2010-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "MD15622",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A108723",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.