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).
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 |
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 |
State | Issuer | Identifier | Type Code |
---|---|---|---|
HI | NPPES | 1649379322 | 01 |
HI | NCPDP | 12-03900 | 01 |
Other Name | Type Code |
---|---|
15th Medical Group | Doing Business As Name - Organization |
Street Address |
15TH MEDICAL GROUP SGSBR 755 SCOTT CIRCLE |
City | HONOLULU |
State | HI |
Zip Code | 96853-5399 |
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 Code | 261QM1100X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Military/U.S. Coast Guard Outpatient |
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] |
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 |
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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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.