Individual provider Active NPI

Michael John Gottner, MD

  • Ophthalmology Physician
  • Honolulu, HI
National Provider Identifier
1992940720
Registry record updated Dec 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD 11277 Issued in HI
Practice address
1620 Ala Moana Blvd
Suite 500
Honolulu, HI 96815-1437
Phone
(808) 955-0255
NPI assigned
Dec 8, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD 11277 HI Primary

Addresses

Primary practice location

1620 Ala Moana Blvd
Suite 500
Honolulu, HI 96815-1437

Mailing address

1620 Ala Moana Blvd
Suite 500
Honolulu, HI 96815-1437
Phone (808) 955-0255

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD 11277HIMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chattanooga Eye Institute,P.C. Ophthalmology PastSince May 31, 1997 Accepting new patients
Russellville Eye Clinic, P.a. Ophthalmology Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/155265c8-cc75-4495-acc6-6ac5bd3a872e/

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.

NPI Registry JSON

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

{
    "created_epoch": "1228694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228694400000",
    "number": "1992940720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 ALA MOANA BLVD",
            "address_2": "SUITE 500",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968151437",
            "telephone_number": "808-955-0255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 ALA MOANA BLVD",
            "address_2": "SUITE 500",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968151437",
            "telephone_number": "808-955-0255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTNER",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-08",
        "last_updated": "2008-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "HI",
            "license": "MD 11277",
            "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 Dec 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.