JJTM LLC

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

7901 Issued in HI

Legal business name

JJTM LLC

Practice address

1301 Punchbowl St
Honolulu, HI 96813-2402

Phone

(808) 547-4771

Fax

(808) 545-8577

NPI assigned

May 20, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Scott D. M. Moon, M.D.

Title

Member/Manager

Phone

(808) 295-5566

Specialties & licenses 1

Addresses

Other identifiers 5

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226620800000",
    "number": "1932366606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 KIIONIONI PL",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968164248",
            "telephone_number": "808-295-5566",
            "fax_number": "808-955-7426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 PUNCHBOWL ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132402",
            "telephone_number": "808-547-4771",
            "fax_number": "808-545-8577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JJTM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-20",
        "last_updated": "2008-11-14",
        "status": "A",
        "authorized_official_last_name": "MOON",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "D. M.",
        "authorized_official_title_or_position": "MEMBER/MANAGER",
        "authorized_official_telephone_number": "808-295-5566",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": "HI",
            "license": "7901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "073512-08",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "073512-06",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "073512-07",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "073512-05",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "F95536(Q)",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Radiation Oncology Physician in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Radiation Oncology Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2008; 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.