US AIR FORCE 15 CPTS FMF PC


Address: 15th Medical Group Sgsbr, 755 Scott Circle, Honolulu, HI 96853-5399
Phone: 8084492295

US AIR FORCE 15 CPTS FMF PC (NPI# 1588638167) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1588638167
Entity Type Organization
Organization Name US AIR FORCE 15 CPTS FMF PC
Other Organization Name 15TH MEDICAL GROUP
Practice Address 15th Medical Group Sgsbr
755 Scott Circle
Honolulu
HI 96853-5399
Practice Telephone 8084492295
Practice Fax Number 8084492297
Mailing Telephone 8084492295
Mailing Fax Number 8084492297
Enumeration Date 2006-02-13
Last Update Date 2014-03-07
Authorized Official Name THERESA MARIE MITCHELL (AIR FORCE UBO ANALYST)
Authorized Official Telephone 7036817613
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 332000000X Military/U.S. Coast Guard Pharmacy Suppliers
N 261QM1101X Clinic/Center
Specialization: Military and U.S. Coast Guard Ambulatory Procedure
Ambulatory Health Care Facilities
Y 261QM1100X Clinic/Center
Specialization: Military/U.S. Coast Guard Outpatient
Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
HI NPPES 1649379322 01
HI NCPDP 12-03900 01

Other Provider/Organization Names

Other Name Type Code
15th Medical Group Doing Business As Name - Organization

Office Location

Street Address 15TH MEDICAL GROUP SGSBR
755 SCOTT CIRCLE
City HONOLULU
State HI
Zip Code 96853-5399

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1467884759 Edward Joseph Tucholski Jr. Dentist 15 Mdg, 755 Scott Circle, Jbphh, HI 96853 2013-08-08
1922232230 Angela Marie Alveo-forbes Military Health Care Provider 375 Mamiya St, Bldg 2140, Hickam Ab, HI 96853 2009-05-14
1205180783 John-michael Fowler Registered Nurse 755 Scott Circle, Jbphh, HI 96853 2012-11-05
1811250442 April A Bronowski Physical Therapist 755 Scott Circle, 15 Mdg, Joint Base Pearl Harbor Hickam, HI 96853 2012-06-19
1245557438 Elaine Mae Davis Dietitian, Registered 755 Scott Cir, Jbphh, HI 96853 2010-04-27
1851492839 Matthew G Hoyt Family Medicine 755 Scott Cir, Jbphh, HI 96853 2006-09-25
1609812163 Joyce Ann Raszewski Nurse Practitioner 755 Scott Circle, Jbphh/hickam, HI 96853 2006-06-22
1720068976 Richard Dale Quintana Family Medicine 15th Medical Group, Hickam Afb, Honolulu, HI 96853 2006-01-21
1124262746 John Craig Bright Military Health Care Provider 15mdos/sgomf 755 Scott Circle, Hickam Afb, HI 96853-3672 2009-04-27
1134759715 David Maldonado Santiago Military Health Care Provider 590 Moffet St, Jbphh, HI 96853-5168 2020-01-22
Find all providers in zip 96853

Taxonomy Information

Taxonomy Code 261QM1100X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Military/U.S. Coast Guard Outpatient

Taxonomy Definition

The Defense Health Program or U.S. Coast Guard funded "fixed" facilities or distinct parts of a facility, providing outpatient medical and dental services, primarily for Uniformed Services beneficiaries. A "fixed" facility is a non-temporary, non-deployed facility. It includes mobile specialty units such as Magnetic Resonance Imaging (MRI) units that may furnish services at the "fixed" facility. It includes, as examples, the institutional portion of outpatient encounters (except Ambulatory Procedure Visits), supplies issued (e.g., glasses, ostomy supplies, crutches), and radiology and laboratory studies. Does not include items issued directly to a patient from an outpatient pharmacy or patient transport.
Notes: Source: TRICARE Management Activity Uniform Business Office User’s Guide [1/1/2005: title modified, definition added; 7/1/2006 title modified, definition modified]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1275781171 Tripler Army Medical Center Clinic/Center 1 Jarrett White Rd, Honolulu, HI 96859 2008-09-04
1316029259 U.S. Coast Guard Isc Honolulu Clinic/Center 400 Sand Island Pkwy, Health Services Division, Honolulu, HI 96819-4326 2006-10-19
1831146281 Tripler Army Medical Center Clinic/Center 1 Jarrett White Rd, Honolulu, HI 96859-5000 2006-05-30

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1114230109 Tripler Army Medical Center Clinic/Center 91-1010 Shangrila St, Suite 100, Kapolei, HI 96707-2161 2010-07-19
1538365036 Tripler Army Medical Center Clinic/Center Bldg 660 Mccornack Road, Dental Clinic, Schofield Barracks, HI 96857 2007-06-22
1750599403 Tripler Army Medical Center Clinic/Center Mccornack Rd Bldg 677, Schofield Barracks, HI 96857 2007-05-18
1841408598 Tripler Army Medical Center Clinic/Center Mccornack Rd Bldg 682, Schofield Barracks, HI 96857 2007-05-18
1275518805 Spectrum Healthcare Resources Clinic/Center 98-340 Koauka Loop, Apt.124, Aiea, HI 96701-4443 2005-12-06
1992311930 Branch Medical Clinic Naval Shipyard Pearl Harbor Clinic/Center 480 Central Ave, Pearl Harbor, HI 96860-4908 2020-09-16
1992953897 Tripler Army Medical Center Clinic/Center 1 Jarrett White Rd, Na Koa Dental Clinic Bldg 678, Tripler Army Medical Center, HI 96859-5001 2008-09-04
1750548277 Uscg Air Station Barbers Point Clinic/Center 1 Coral Sea St, Kapolei, HI 96707-3693 2008-05-21
1457550204 Branch Medical Clinic Kaneohe Clinic/Center 480 Central Ave, Attn: Bhc Kaneohe Hawaii, Pearl Harbor, HI 96860-4908 2007-07-12
1073712824 Branch Medical Clinic Camp Smith Medical Annex Clinic/Center 480 Central Ave, Code 02, Pearl Harbor, HI 96860-4908 2007-07-12
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Competitor

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City HONOLULU
Zip Code 96853

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Dataset Information

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.

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