Individual provider Active NPI

Antonio Komotar, LMHC

  • Case Management Agency
  • Hilo, HI
National Provider Identifier
1902126592
Registry record updated Jun 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
License
220 Issued in HI
Practice address
357 Waianuenue Ave
Hilo, HI 96720-2439
Phone
(808) 935-3481
Fax
(808) 935-4436
NPI assigned
Jun 4, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X 220 HI Primary

Addresses

Primary practice location

357 Waianuenue Ave
Hilo, HI 96720-2439

Mailing address

357 Waianuenue Ave
Hilo, HI 96720-2439
Phone (808) 935-3481

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
220HIMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1275609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275609600000",
    "number": "1902126592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "357 WAIANUENUE AVE",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967202439",
            "telephone_number": "808-935-3481",
            "fax_number": "808-935-4436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "357 WAIANUENUE AVE",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967202439",
            "telephone_number": "808-935-3481",
            "fax_number": "808-935-4436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMOTAR",
        "first_name": "ANTONIO",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-04",
        "last_updated": "2010-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "HI",
            "license": "220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilo, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.