Individual provider Active NPI

Jere H.E. Loo, OD

  • Optometrist
  • Lihue, HI
National Provider Identifier
1962561324
Registry record updated Jun 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD-254 Issued in HI
Practice address
3-2600 Kaumualii Hwy
Suite C 3
Lihue, HI 96766-2040
Phone
(808) 245-8564
NPI assigned
Dec 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD-254 HI Primary

Addresses

Primary practice location

3-2600 Kaumualii Hwy
Suite C 3
Lihue, HI 96766-2040

Mailing address

3-2600 Kaumualii Hwy
Ste 1508
Lihue, HI 96766-2023
Phone (808) 245-8564

Other identifiers 1

IdentifierTypeStateIssuer
025937-01MedicaidHI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051019000733 HI Practitioner - Optometry 5597781518 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3-2600 Kaumualii Hwy
Suite 1508
Lihue, HI 96766-2023
Phone (808) 245-8564

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OD-254HIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Arthur W. H. Loo, O.D., Inc. Optometrist CurrentSince Aug 1, 2007 Accepting new patients

Locations

3-2600 Kaumualii Hwy
Ste 1508
Lihue, HI 96766
Phone (808) 245-8564

3-2600 Kaumualii Hwy
Ste C3
Lihue, HI 96766
Phone (808) 245-8564

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560988800000",
    "number": "1962561324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3-2600 KAUMUALII HWY",
            "address_2": "STE 1508",
            "city": "LIHUE",
            "state": "HI",
            "postal_code": "967662023",
            "telephone_number": "808-245-8564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3-2600 KAUMUALII HWY",
            "address_2": "SUITE C 3",
            "city": "LIHUE",
            "state": "HI",
            "postal_code": "967662040",
            "telephone_number": "808-245-8564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOO",
        "first_name": "JERE",
        "middle_name": "H.E.",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2019-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "HI",
            "license": "OD-254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "025937-01",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lihue, HI

Sources for this page

Verify at the official NPI Registry.