Individual provider Active NPI

Richard Lance Dejournett, M.D.

  • Diagnostic Radiology Physician
  • Honolulu, HI
National Provider Identifier
1982691341
Registry record updated Nov 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD02562 Issued in HI
Practice address
1380 Lusitana St
Second Floor
Honolulu, HI 96813-2449
Phone
(808) 599-4471
Fax
(808) 523-3849
NPI assigned
Sep 30, 2005
Last updated
Nov 2, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD02562 HI Primary

Addresses

Primary practice location

1380 Lusitana St
Second Floor
Honolulu, HI 96813-2449

Mailing address

1380 Lusitana St
Second Floor
Honolulu, HI 96813-2449

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20210111001763 TX Practitioner - Diagnostic Radiology 0749170520 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD02562HIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Dec 28, 2020 Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital Current Accepting new patients
Open and Wide MRI LLC Diagnostic Radiology Past Accepting new patients
Frank J Voralik MD Diagnostic Radiology Past Accepting new patients
Dwight James Lin MD Inc PastSince Sep 10, 2001 Accepting new patients

Locations

6 Road 7586
Bloomfield, NM 87413
Phone (505) 368-8015

Interoperability endpoints

  • Direct secure messaging: rdejournett232625@direct.urmc.rochester.edu
  • Direct secure messaging: rdejournett297293@wellspan.direct-ci.com

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1982691341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 LUSITANA ST",
            "address_2": "SECOND FLOOR",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 LUSITANA ST",
            "address_2": "SECOND FLOOR",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132449",
            "telephone_number": "808-599-4471",
            "fax_number": "808-523-3849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEJOURNETT",
        "first_name": "RICHARD",
        "middle_name": "LANCE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "HI",
            "license": "MD02562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.