NPIMap

Individual provider Active NPI

John R Vaz, MD

  • Infectious Disease Physician
  • Wailuku, HI
National Provider Identifier
1952556201
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
D0075692 Issued in MD
Practice address
1881 Nani St
Wailuku, HI 96793-1811
Phone
(808) 871-7772
NPI assigned
Nov 28, 2008
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0075692 MD
Internal Medicine Physician 207R00000X 18922 HI
Infectious Disease Physician 207RI0200X 18922 HI
Infectious Disease Physician 207RI0200X D0075692 MD Primary

Addresses

Primary practice location

1881 Nani St
Wailuku, HI 96793-1811

Mailing address

1881 Nani St
Wailuku, HI 96793-1811
Phone (808) 871-7772

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170621001023 HI Practitioner - Internal MedicinePractitioner - Infectious Disease 5698916401 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Infectious Disease
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Clinic of Maui IncGroup PAC ID 2466365440, 20 clinicians

Practice addresses (Care Compare)

1881 Nani St
Wailuku, HI 96793-1811
Phone (808) 871-7772

670 Waiale Rd
Apt a
Wailuku, HI 96793-2376
Phone (808) 872-4099

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
18922HIMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Clinic of Maui, Inc. Current Accepting new patients
Community Clinic of Maui, Inc. CurrentSince May 22, 2017 Accepting new patients
Community Clinic of Maui, Inc. CurrentSince May 22, 2017 Accepting new patients
Community Clinic of Maui, Inc. PastSince Apr 14, 2024 Accepting new patients

Locations

1881 Nani St
Wailuku, HI 96793
Phone (808) 871-7772

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Malama I Ke Ola Health CenterWailuku, HI, CCN 121819 Federally qualified health center Corporate Officer
W-2 Managing Employee		 Jul 1, 2022
Jul 1, 2022
Malama I Ke Ola Health CenterWailuku, HI, CCN 121812 Federally qualified health center Corporate Officer
W-2 Managing Employee
Operational/Managerial Control		 Jul 1, 2022
Jul 1, 2022
Jul 1, 2022
Lighthouse Healthcare Advisors, LLCKihei, HI, CCN 121014 Federally qualified health center Contracted Managing Employee
Corporate Officer		 Jul 1, 2022
Jul 1, 2022
Malama I Ke Ola Health CenterLahaina, HI, CCN 121015 Federally qualified health center Corporate Officer
W-2 Managing Employee		 Jul 1, 2022
Jul 1, 2022

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

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": "1227830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1952556201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1881 NANI ST",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967931811",
            "telephone_number": "808-871-7772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1881 NANI ST",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967931811",
            "telephone_number": "808-871-7772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZ",
        "first_name": "JOHN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-28",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0075692",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "18922",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "HI",
            "license": "18922",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MD",
            "license": "D0075692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wailuku, HI

Sources for this page

Verify at the official NPI Registry.