Individual provider Active NPI

Joan Claudine Quiba, OD

  • Optometrist
  • Kapolei, HI
National Provider Identifier
1912498643
Registry record updated May 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
873 Issued in HI
Practice address
4589 Kapolei Pkwy
Kapolei, HI 96707-1879
Phone
(808) 674-3913
NPI assigned
May 29, 2018
Last updated
May 29, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 873 HI Primary

Addresses

Primary practice location

4589 Kapolei Pkwy
Kapolei, HI 96707-1879

Mailing address

91-206 Wahane PL
Kapolei, HI 96707-3109
Phone (808) 368-6812

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI, OR2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190301002309 HI Practitioner - Optometry 1254670672 Reassigns benefits to 1 organization
I20230628003499 OR Practitioner - Optometry 1254670672 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bridgetown Optometric Associates LLCGroup PAC ID 1254764996, 4 clinicians

Practice addresses (Care Compare)

12923 NW Cornell Rd
Suite 203
Portland, OR 97229-5834
Phone (503) 645-5076

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
873HIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Christopher Sween Optometrist Inc Optometrist CurrentSince Nov 13, 2018 Accepting new patients
Bridgetown Optometric Associates LLC Optometrist CurrentSince Jul 1, 2023 Accepting new patients
Optimeyes PastSince Jul 1, 2023 Accepting new patients

Locations

4589 Kapolei Pkwy
Kapolei, HI 96707
Phone (808) 674-3902

12923 NW Cornell Rd
Ste 203
Portland, OR 97229
Phone (503) 645-5076

11577 SW Pacific Hwy
Tigard, OR 97223
Phone (503) 968-5249

Organizations & group practices 3

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": "1527552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527552000000",
    "number": "1912498643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91-206 WAHANE PL",
            "city": "KAPOLEI",
            "state": "HI",
            "postal_code": "967073109",
            "telephone_number": "808-368-6812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4589 KAPOLEI PKWY",
            "city": "KAPOLEI",
            "state": "HI",
            "postal_code": "967071879",
            "telephone_number": "808-674-3913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUIBA",
        "first_name": "JOAN CLAUDINE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-29",
        "last_updated": "2018-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "HI",
            "license": "873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kapolei, HI

Sources for this page

Verify at the official NPI Registry.