DR. ETHAN THACHER ROUTT (NPI# 1194112391) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194112391 |
| Entity Type | Individual |
| Full Name | DR. ETHAN THACHER ROUTT |
| Credential | MD |
| Practice Address |
2226 Liliha St Ste 302 Honolulu HI 96817-1605 |
| Practice Telephone | 8085858008 |
| Mailing Telephone | 8085858008 |
| Enumeration Date | 2015-04-25 |
| Last Update Date | 2020-10-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | MD-20864 | HI | Allopathic & Osteopathic Physicians |
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
MD-20864 | HI | Allopathic & Osteopathic Physicians |
| Street Address |
2226 LILIHA ST STE 302 |
| City | HONOLULU |
| State | HI |
| Zip Code | 96817-1605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528376597 | Crystal Chanel Cabansag | Physician Assistant | 2226 Liliha St Ste 302, Honolulu, HI 96817-1605 | 2010-09-23 |
| 1154866473 | Golden Dermatology LLC | Dermatology | 2226 Liliha St Ste 302, Honolulu, HI 96817-1605 | 2016-12-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942810676 | Tracey Lorraine Ramelb Mayola | Nurse's Aide | 36 Bates St., Unit A1, Honolulu, HI 96817 | 2020-08-06 |
| 1710503032 | Ray & Cee Inc | Counselor | Heavenly Counsel, 985 Dillingham Blvd Suite 100, Honolulu, HI 96817 | 2020-06-23 |
| 1982238093 | Healthy Mothers Healthy Babies Coalition of Hawaii | Public Health or Welfare | 245 N Kukui St #102a, Kukui Center, Honolulu, HI 96817 | 2020-02-27 |
| 1770042160 | Garza Wellness Care Center, LLC | Chiropractor | 1744 Liliha St. Suite #201, Honolulu, HI 96817 | 2019-03-15 |
| 1932688165 | Behavior Analysis and Family Therapy Center of Hawaii | Marriage & Family Therapist | 200 North Vineyard Blvd, Suite B 270, Honolulu, HI 96817 | 2018-08-08 |
| 1013409382 | Marleina Dee Capua | Behavior Technician | 200 N Vineyard Blvd # A600, Honolulu, HI 96817 | 2018-06-03 |
| 1811496623 | Kimberly Jee Ying Wun | Nurse Practitioner | 860 Iwilei Road, Honolulu, HI 96817 | 2018-02-07 |
| 1144737925 | Cancer Center of Hawaii, LLC | Radiology | 2226 Liliha St, #b2, Honolulu, HI 96817 | 2018-01-03 |
| 1700315355 | Thomas Bishop | Behavioral Analyst | 200 N. Vineyard Blvd. Suite #153, Honolulu, HI 96817 | 2017-06-07 |
| 1760843890 | Kanna Dokgo | Nurse Practitioner | 321 Kuakini St., Honolulu, HI 96817 | 2016-03-17 |
| Find all providers in zip 96817 | ||||
| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
| Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154866473 | Golden Dermatology LLC | Dermatology | 2226 Liliha St Ste 302, Honolulu, HI 96817-1605 | 2016-12-21 |
| 1710302765 | Hawaii Skin Cancer Center, LLC | Dermatology | 500 Ala Moana Blvd, Honolulu, HI 96813-4920 | 2014-02-27 |
| 1922234780 | Karl Vance | Dermatology | 1356 Lusitana St Fl 7, Honolulu, HI 96813-2421 | 2009-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265902670 | Kenny R. Malott M.d. Inc. | Dermatology | 375 Huku Lii Pl Ste 201, Kihei, HI 96753-8996 | 2018-11-28 |
| 1174624019 | Alan S. W. Song | Dermatology | 1300 N Holopono St Ste 215, Kihei, HI 96753-6945 | 2006-09-25 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.