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NATHAN P TOMITA D.O.
NPI 1255312401
Surgery in Kailua Kona, HI

Active since November 07, 2005PECOS EnrolledAccepts Medicare Assignment
75-170 HUALALAI RD STE D216A, KAILUA KONA, HI 96740(808) 313-8338(808) 313-8339 Get Directions Write a Review

NPPES record last updated: November 19, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 19, 2024, Apr 19, 2021 (2 updates tracked since 2021).

About Nathan P Tomita D.o. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NATHAN P TOMITA D.O. (NPI 1255312401) is an individual surgery provider in Kailua Kona, Hawaii, licensed in Hawaii (DOS1441) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS, is affiliated with Kona Community Hospital, and is a graduate of Michigan State University College Of Osteopathic Medicine (1998).

NPPES Registry Identity

NPI1255312401
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameNATHAN P TOMITACredential: D.O.
Location Address75-170 HUALALAI RD STE D216AKailua Kona, HI 96740-1779
Mailing Address75-170 Hualalai Rd Ste D216aKailua Kona, HI 96740-1779 · (808) 313-8338 · Fax (808) 313-8339
Phone(808) 313-8338
Fax(808) 313-8339
Sole ProprietorYes
Medical School CMSMichigan State University College Of Osteopathic MedicineGraduated 1998
Enumeration DateNovember 7, 2005
Last NPPES UpdateNovember 19, 20242 updates tracked since enumeration
NPPES CertifiedNovember 19, 2024
✔ NPI 1255312401 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
Licenses✔ Licensed in HI · DOS1441✔ Licensed in MI · 5101013860
Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

75-170 HUALALAI RD STE D216A, Kailua Kona, HI 96740
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Other Identifiers 2

Medicaid114583911MI
Other0257801385MI · Bcbsm

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HMSA.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Nathan P Tomita D.o. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5698758340
PECOS Enrollment IDI20120803000218
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
189 services123 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
141 services90 patients
Destruction of first incompetent vein of arm or leg using radiofrequency and imaging guidance 36475
This procedure involves using radiofrequency energy, a type of heat energy, to close off an unhealthy vein in your arm or leg. Imaging guidance helps ensure precise targeting of the vein. This helps improve blood flow by rerouting it through healthier veins.
118 services51 patients
Injection of chemical agent into single incompetent vein of leg using ultrasound guidance 36465
This procedure involves injecting a chemical agent into a non-functioning vein in your leg. Ultrasound technology is used to accurately locate the vein. The chemical helps to close off the vein, rerouting blood flow to healthier veins.
56 services38 patients
Ultrasonic guidance for needle placement 76942
Ultrasonic guidance for needle placement is a technique where sound waves create images that help accurately position the needle during procedures. This method ensures precision, minimizes discomfort, and increases safety.
40 services37 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
40 services40 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Kona Community Hospital

Acute Care Hospitals · Kealakekua, HI
1/5 CMS rating
OwnershipGovernment - State
CMS Certification Number120019
Location79-1019 Haukapila StreetKealakekua, HI 96750 · Hawaii County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 96740 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$92.50 typical visit price
range $60.53 – $180.05
Typical copayment $23.12 (range $15.13 – $45.01)
Most-billed visit code 99203
Established Patient
$74.92 typical visit price
range $20.09 – $147.56
Typical copayment $18.73 (range $5.02 – $36.89)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
100%151 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing A6196
DME-Medical/Surgical Supplies · category DA023N
1 supplier43 claims111 services$7.63 avg. paid by Medicare
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing A6209
DME-Medical/Surgical Supplies · category DA023N
1 supplier33 claims103 services$7.77 avg. paid by Medicare
Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing A6252
DME-Medical/Surgical Supplies · category DA023N
1 supplier27 claims386 services$3.89 avg. paid by Medicare
Pneumatic compressor, segmental home model without calibrated gradient pressure E0651
DME-Other DME · category DE000N
2 suppliers11 claims11 services$660.81 avg. paid by Medicare
Segmental pneumatic appliance for use with pneumatic compressor, full leg E0667
DME-Other DME · category DE000N
2 suppliers11 claims22 services$580.40 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SENSEI SURGERY, INC
Clinic/Center
75-170 HUALALAI RD STE D216A
KAILUA KONA, HI 96740
Hawaii County (808) 313-8338

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nathan Tomita's NPI number?

The NPI number for Nathan Tomita is 1255312401. It was assigned to this individual provider in the NPPES registry on November 7, 2005.

Where is Nathan Tomita located?

Nathan Tomita practices at 75-170 Hualalai Rd Ste D216a, Kailua Kona, HI 96740. The listed phone number is (808) 313-8338.

What is Nathan Tomita's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Nathan Tomita enrolled in Medicare?

Yes. Nathan Tomita is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Nathan Tomita accept?

Health plans from HMSA list Nathan Tomita as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Nathan Tomita affiliated with any hospitals?

According to CMS data, Nathan Tomita is affiliated with Kona Community Hospital.

When was this NPI record last updated?

The NPPES record for Nathan Tomita was last updated on November 19, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.