Provider Type Icon

DR. JIVIN GERARD TANTISIRA M.D. NPI 1104889583


NPI Information

NPI: 1104889583
Provider Name: DR. JIVIN GERARD TANTISIRA, M.D.
Classification: Ophthalmology - 207W00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
450 HOOKAHI ST
WAILUKU, HI
ZIP 96793
Phone: (808) 877-3984
Get Directions

DR. Jivin Gerard Tantisira, M.D. is an ophthalmology in Wailuku, HI with 37 years of experience. The provider is an ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. DR. Jivin Gerard Tantisira, M.D. NPI is 1104889583. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: YALE UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1987

The provider's business location address is:

450 HOOKAHI ST
WAILUKU, HI
ZIP 96793-447
Phone: (808) 877-3984
Fax: (808) 871-6498

The NPI 1104889583 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits (HCPCS:92014)
  • Diagnostic imaging of retina (HCPCS:92134)
  • Eye and medical examination for diagnosis and treatment, established patient (HCPCS:92012)
  • Measurement of field of vision during daylight conditions (HCPCS:92083)
  • Diagnostic imaging of optic nerve of eye (HCPCS:92133)
  • Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits (HCPCS:92004)
  • Photography of the retina (HCPCS:92250)

The enumeration date for this NPI number is 4/7/2006 and was last updated on 8/30/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207W00000XOphthalmologyMD 9427HAWAIIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11447298344OTHERHAWAIIALOHA EYE CLINIC, LTD. NPI ID
220992-4OTHERHAWAIIHMSA
300264901MEDICAIDHAWAII

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.