Patti K M Endo MD Inc

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MD9088 Issued in HI

Legal business name

PATTI K M ENDO MD INC

Practice address

135 S Wakea Ave
Suite 111
Kahului, HI 96732-1385

Phone

(808) 877-3635

Fax

(808) 877-4363

NPI assigned

Apr 11, 2011

Last updated

Apr 11, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Patti K Endo, M.D.NPI 1699870956

Title

President

Phone

(808) 877-3635

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in HI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Patti K.M. Endo, M.D.

  • Dermatology Physician
  • Wailuku, HI
  • NPI 1699870956
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1302480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302480000000",
    "number": "1972893980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 S WAKEA AVE",
            "address_2": "SUITE 111",
            "city": "KAHULUI",
            "state": "HI",
            "postal_code": "967321385",
            "telephone_number": "808-877-3635",
            "fax_number": "808-877-4363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 S WAKEA AVE",
            "address_2": "SUITE 111",
            "city": "KAHULUI",
            "state": "HI",
            "postal_code": "967321385",
            "telephone_number": "808-877-3635",
            "fax_number": "808-877-4363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATTI K M ENDO MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-11",
        "last_updated": "2011-04-11",
        "status": "A",
        "authorized_official_last_name": "ENDO",
        "authorized_official_first_name": "PATTI",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "808-877-3635",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "HI",
            "license": "MD9088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07506301",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Kahului, HI
• Providers in Kahului, HI by specialty
• Dermatology Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2011; 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.