DR. PETER H. TAKEYAMA (MD) – Neuroradiology Physician, NPI 1962418038

DR. PETER H. TAKEYAMA (MD) is a healthcare provider. based in Fort wayne, Indiana. specializing in DIAGNOSTIC RADIOLOGY. They hold the professional credentials MD. They hold a License No. 01074526A (IN). The NPI Number for DR. PETER H. TAKEYAMA (MD) is 1962418038

Main info

Male
24 Years Of Experience
Accepts Medicare Assignment
Name
DR. PETER H. TAKEYAMA (MD)
NPI
1962418038
Phone
(260) 432-1568
Address
PO BOX 80070
Enumeration Date
31 July 2006
Last Update Date
12 May 2021

Doctor Profile

Medical School Name
UNIVERSITY OF ROCHESTER SCHOOL OF MEDICINE AND DENTISTRY
Secondary Phone
8084323800
Graduation Year
2002 (24 years ago)
PAC ID
9638295090
Group Practice PAC ID
7618880667
Professional Enrollment ID
I20110425000298
Address ID
HI967442017KA45602HWYX400

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/interconnect-prodhim/wcf/epic.community.hie/xcpdrespondinggateways
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience76
Completeness85
Years active:19State licenses:2Other namesUpdated within 12 months

847 DIAGNOSTIC RADIOLOGY in IN

Provider Addresses for DR. PETER H. TAKEYAMA (MD)

  • PO BOX 80070

    FORT WAYNE, IN 468980070

    Phone: (260) 432-1568

    Type: Mailing

  • 5001 US HIGHWAY 30 W STE D

    FORT WAYNE, IN 468189701

    Phone: (260) 432-1568

    Type: Location

  • 3288 MOANALUA RD

    HONOLULU, HI 968191469

    Phone: (808) 432-0000

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

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

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-04-25

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20110425000298IDiagnostic RadiologyHITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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
71045X-ray of chest, 1 view4837$0
71046X-ray of chest, 2 views1919$0
View full utilization report →

Insurance plans in this area (ZIP 46898)

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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: 7618880667View full group profile
NameSpecialtyState
P S Y C H I A T R YCA
O P T O M E T R YHI
-HI
Physician AssistantHI
Emergency MedicineVA
Orthopedic SurgeryHI
Internal MedicineHI
Orthopedic SurgeryHI
-HI
-CO

Reviews

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Frequently asked questions

What is the standard ID for DR. PETER H. TAKEYAMA (MD) in the U.S.?
In the U.S., DR. PETER H. TAKEYAMA (MD) is identified by NPI 1962418038.
Should I treat DR. PETER H. TAKEYAMA (MD) as an active provider?
Patients and plans typically see DR. PETER H. TAKEYAMA (MD) as active in the national extract.
Which specialty label fits DR. PETER H. TAKEYAMA (MD)?
NPPES ties DR. PETER H. TAKEYAMA (MD) to Neuroradiology Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
What geographic area is tied to DR. PETER H. TAKEYAMA (MD)?
DR. PETER H. TAKEYAMA (MD) is associated with Fort Wayne, Indiana in the same public data insurers reference.
Who maintains DR. PETER H. TAKEYAMA (MD)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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