Organization Active NPI

Richard a Ridao MD LLC

  • Internal Medicine Physician
  • Honolulu, HI
National Provider Identifier
1932304565
Registry record updated Oct 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
6904 Issued in HI
Legal business name
RICHARD A RIDAO MD LLC
Practice address
1481 S King St Ste 343
Honolulu, HI 96814-2602
Phone
(808) 678-1900
NPI assigned
Jun 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2007

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

Authorized official

Name
Richard A Ridao, MDNPI 1730122060
Title
Owner
Phone
(808) 678-1900

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 6904 HI Primary

Addresses

Primary practice location

1481 S King St Ste 343
Honolulu, HI 96814-2602

Mailing address

PO Box 25370
Honolulu, HI 96825-0370
Phone (808) 536-0300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070907000464 HI Part B Supplier - Clinic/Group Practice 9335232263 Receives reassigned benefits from 1 practitioner
Practice locations: Honolulu, HI

National Provider Directory

National Provider Directory

Locations

1451 S King St
Ste 309
Honolulu, HI 96814
Phone (808) 593-2155

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": "1181779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193097600000",
    "number": "1932304565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25370",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968250370",
            "telephone_number": "808-536-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1481 S KING ST STE 343",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968142602",
            "telephone_number": "808-678-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD A RIDAO MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-14",
        "last_updated": "2007-10-23",
        "status": "A",
        "authorized_official_last_name": "RIDAO",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-678-1900",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "6904",
            "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 Oct 23, 2007; 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.