Active NPI
Imrusty Simon, RBT
- Personal Care Attendant
- Honolulu, HI
National Provider Identifier
1922774884
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Personal Care Attendant
- License
- RBT-20-141891
- Practice address
- 1405 Ernest St Apt 4
Honolulu, HI 96822-3879 - Phone
- (808) 439-3147
- NPI assigned
- Aug 20, 2021
- Last updated
- Aug 20, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | RBT-20-141891 | HI | Primary |
Addresses
Primary practice location
1405 Ernest St Apt 4
Honolulu, HI 96822-3879
Mailing address
1405 Ernest St Apt 4
Honolulu, HI 96822-3879
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
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-20-141891 | HI | MD | Personal Care Attendant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629417600000",
"number": "1922774884",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1405 ERNEST ST APT 4",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968223879"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1405 ERNEST ST APT 4",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968223879",
"telephone_number": "808-439-3147"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMON",
"first_name": "IMRUSTY",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-08-20",
"last_updated": "2021-08-20",
"certification_date": "2021-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "3747P1801X",
"taxonomy_group": "",
"desc": "Technician, Personal Care Attendant",
"state": "HI",
"license": "RBT-20-141891",
"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 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.