Unknown Individual – Urology Physician, NPI 1285699702

Unknown Individual is a healthcare provider. based in Honolulu, Hawaii. specializing in Urology Physician. They hold a License No. MD13484 (HI). The NPI Number for Unknown Individual is 1285699702

Main info

Organization
Inactive
27 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1285699702
Phone
(808) 523-9400
Address
1380 LUSITANA ST
Deactivation Date
11 January 2023

Doctor Profile

Medical School Name
UNIVERSITY OF HAWAII JOHN A. BURNS SCHOOL OF MEDICINE
Secondary Phone
8084866000
Graduation Year
1999 (27 years ago)
PAC ID
7719900471
Group Practice PAC ID
6406746916
Professional Enrollment ID
I20060109000381
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Queen's Physicians Office Building 1, 1380, Lusitana Street, Hawaii Capital Historic District, Honolulu, Honolulu County, Hawaii, 96813, United States

    SUITE #1004

    HONOLULU, HI 968132461

    Phone: (808) 523-9400

    Fax: (808) 526-3080

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $36.

Total Amount is formed as General ($36) + Research ($0) + Ownership ($0) = $36.

Last reported payment date: 2023-06-15 • Largest payer in this snapshot: C. R. Bard, Inc. & Subsidiaries ($36).

Total Amount

$36

General + Research + Ownership

Payments

2

Total payment records

General Amount

$36

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-06-15

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 96813)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6406746916View full group profile
NameSpecialtyState
Family PracticeWA
-HI
General SurgeryCA
Nurse PractitionerHI
Orthopedic SurgeryHI
N E U R O L O G YHI
Family PracticeHI
Registered Dietitian Or Nutrition ProfessionalHI
Cardiovascular Disease (Cardiology)HI
H E M A T O L O G Y/ O N C O L O G YCA

Reviews

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Unknown Individual uses 1285699702.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Urology Physician in this dataset. Clinical services aligned with this taxonomy classification.
What area does Unknown Individual serve?
Unknown Individual's listing highlights Honolulu, Hawaii; more addresses can appear in NPPES.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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Queen's Physicians Office Building 1, 1380, Lusitana Street, Hawaii Capital Historic District, Honolulu, Honolulu County, Hawaii, 96813, United States
NPI: 1013972603