Unknown Individual – Emergency Medicine Physician, NPI 1508803768

Unknown Individual is a healthcare provider. based in Waipahu, Hawaii. specializing in Emergency Medicine Physician. They hold a License No. A61240 (CA). The NPI Number for Unknown Individual is 1508803768

Main info

Organization
Inactive
40 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1508803768
Phone
(808) 677-1433
Address
94-300 FARRINGTON HWY
Deactivation Date
13 November 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1986 (40 years ago)
PAC ID
6901792936
Professional Enrollment ID
I20150511000914
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

  • Shakey's Pizza, 94-060, Farrington Highway, West Loch, Waipahu, Honolulu County, Hawaii, 96797, United States

    SUITE F8

    WAIPAHU, HI 967972699

    Phone: (808) 677-1433

    Fax: (808) 677-1676

    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 12 Open Payments records for all available years, with a total value of $237.

Total Amount is formed as General ($237) + Research ($0) + Ownership ($0) = $237.

Last reported payment date: 2024-11-15 • Largest payer in this snapshot: Bayer Healthcare Pharmaceuticals Inc. ($63).

Total Amount

$237

General + Research + Ownership

Payments

12

Total payment records

General Amount

$237

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-15

Latest reported date

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes12158$0
99203New patient office or other outpatient visit, 30-44 minutes3838$0
99214Established patient office or other outpatient visit, 30-39 minutes2214$0
View full utilization report →

Insurance plans in this area (ZIP 96797)

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Reviews

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Frequently asked questions

What identifier follows Unknown Individual across health systems?
The NPI 1508803768 uniquely identifies Unknown Individual in U.S. healthcare data.
What happens when Unknown Individual's NPI is not active?
Public data lists Unknown Individual outside the active bucket for this identifier.
Which specialty label fits Unknown Individual?
NPPES ties Unknown Individual to Emergency Medicine Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with Waipahu, Hawaii in the same public data insurers reference.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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