Organization Active NPI

Roy M Matsuyama MD LLC

  • Gastroenterology Physician
  • Kahului, HI
National Provider Identifier
1982094975
Registry record updated Feb 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
17851 Issued in HI
Legal business name
ROY M MATSUYAMA MD LLC
Practice address
173 Hoohana St
Suite 104
Kahului, HI 96732-2482
Phone
(808) 871-7222
Fax
(808) 871-2222
NPI assigned
Jan 28, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2015

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

Authorized official

Name
Roy M Matsuyama, MDNPI 1144356783
Title
Owner
Phone
(808) 871-7222

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X 17851 HI Primary

Addresses

Primary practice location

173 Hoohana St
Suite 104
Kahului, HI 96732-2482

Mailing address

173 Hoohana St
Suite 104
Kahului, HI 96732-2482
Phone (808) 871-7222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150305000746 HI Part B Supplier - Clinic/Group Practice 0648596890 Receives reassigned benefits from 1 practitioner
Practice locations: Kahului, HI

National Provider Directory

National Provider Directory

Locations

173 Hoohana St
Ste 104
Kahului, HI 96732
Phone (808) 871-7222

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1422403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422835200000",
    "number": "1982094975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "173 HOOHANA ST",
            "address_2": "SUITE 104",
            "city": "KAHULUI",
            "state": "HI",
            "postal_code": "967322482",
            "telephone_number": "808-871-7222",
            "fax_number": "808-871-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 HOOHANA ST",
            "address_2": "SUITE 104",
            "city": "KAHULUI",
            "state": "HI",
            "postal_code": "967322482",
            "telephone_number": "808-871-7222",
            "fax_number": "808-871-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROY M MATSUYAMA MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-28",
        "last_updated": "2015-02-02",
        "status": "A",
        "authorized_official_last_name": "MATSUYAMA",
        "authorized_official_first_name": "ROY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-871-7222",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "HI",
            "license": "17851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kahului, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2015; 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.