Individual provider Active NPI

Janelle Janise Kikumi Otsuji, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Tucson, AZ
National Provider Identifier
1972958155
Registry record updated May 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
R75474 Issued in AZ
Practice address
1501 N Campbell Ave
Tucson, AZ 85724-5108
Phone
(808) 381-2234
NPI assigned
Apr 26, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X 60113 AZ
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X R75474 AZ Primary

Addresses

Primary practice location

1501 N Campbell Ave
Tucson, AZ 85724-5108

Mailing address

1501 N Campbell Ave
P.O. Box 245108
Tucson, AZ 85724-5108
Phone (808) 381-2234

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210701003431 HI Practitioner - Pathology 4284924739 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Hawaii John a. Burns School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pan Pacific Pathologists LLCGroup PAC ID 0941190474, 19 clinicians

Practice addresses (Care Compare)

99 -193 Aiea Heights Dr
Aiea, HI 96701-3919
Phone (808) 677-7999

Hospital & facility affiliations

  • Pali Momi Medical Center Hospital, Aiea, HI, CCN 120026
  • Straub Clinic and Hospital Hospital, Honolulu, HI, CCN 120022
  • Maui Memorial Medical Center Hospital, Wailuku, HI, CCN 120002

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60113AZMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pan Pacific Pathologists, LLC Single Specialty CurrentSince Aug 15, 2021 Accepting new patients
Clinical Laboratories of Hawaii LLP PastSince Aug 15, 2021 Accepting new patients

Locations

99-193 Aiea Heights Dr
Aiea, HI 96701
Phone (808) 679-4243

1190 Waianuenue Ave
Hilo, HI 96720
Phone (808) 932-3000

33 Lanihuli St
Hilo, HI 96720
Phone (808) 935-4814

Organizations & group practices 2

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1461628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590796800000",
    "number": "1972958155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 N CAMPBELL AVE",
            "address_2": "P.O. BOX 245108",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857245108",
            "telephone_number": "808-381-2234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 N CAMPBELL AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857245108",
            "telephone_number": "808-381-2234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTSUJI",
        "first_name": "JANELLE",
        "middle_name": "JANISE KIKUMI",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-26",
        "last_updated": "2020-05-30",
        "certification_date": "2020-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "AZ",
            "license": "60113",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "AZ",
            "license": "R75474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.