Active NPI
Nagisa Stacy Matsumoto, DO
- Pediatrics Physician
- Honolulu, HI
National Provider Identifier
1982459509
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- DOSR-647
- Practice address
- 1319 Punahou St
Honolulu, HI 96826-1080 - Phone
- (808) 983-6000
- NPI assigned
- Apr 18, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | DOSR-647 | HI | Primary |
Addresses
Primary practice location
1319 Punahou St
Honolulu, HI 96826-1080
Mailing address
1319 Punahou St
Honolulu, HI 96826-1001
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DOSR-647 | HI | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1713398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713398400000",
"number": "1982459509",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1319 PUNAHOU ST",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968261001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1319 PUNAHOU ST",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968261080",
"telephone_number": "808-983-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATSUMOTO",
"first_name": "NAGISA",
"middle_name": "STACY",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-04-18",
"last_updated": "2024-04-18",
"certification_date": "2024-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "HI",
"license": "DOSR-647",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Honolulu, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.