Organization Active NPI

Suzanne P. Kaneshiro, M.D., Inc.

  • Dermatology Physician
  • Honolulu, HI
National Provider Identifier
1922108463
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD-11538 Issued in HI
Legal business name
SUZANNE P. KANESHIRO, M.D., INC.
Practice address
405 N Kuakini St
Suite 1110
Honolulu, HI 96817-6300
Phone
(808) 599-3520
Fax
(808) 599-3524
NPI assigned
Sep 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Suzanne Peggy Kaneshiro, M.D.NPI 1932209475
Title
President
Phone
(808) 599-3520

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X MD-11538 HI Primary

Addresses

Primary practice location

405 N Kuakini St
Suite 1110
Honolulu, HI 96817-6300

Mailing address

405 N Kuakini St
Suite 1110
Honolulu, HI 96817-6300
Phone (808) 599-3520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080123000714 HI Part B Supplier - Clinic/Group Practice 6800978362 Receives reassigned benefits from 1 practitioner
Practice locations: Honolulu, HI

National Provider Directory

National Provider Directory

Locations

405 N Kuakini St
Ste 1110
Honolulu, HI 96817
Phone (808) 599-3520

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922108463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 N KUAKINI ST",
            "address_2": "SUITE 1110",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968176300",
            "telephone_number": "808-599-3520",
            "fax_number": "808-599-3524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 N KUAKINI ST",
            "address_2": "SUITE 1110",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968176300",
            "telephone_number": "808-599-3520",
            "fax_number": "808-599-3524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUZANNE P. KANESHIRO, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KANESHIRO",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_middle_name": "PEGGY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "808-599-3520",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "HI",
            "license": "MD-11538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.