Provider Demographics
NPI:1528021862
Name:CALL, JASON T (MD)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:T
Last Name:CALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 MAUI LANI PKWY
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-2416
Mailing Address - Country:US
Mailing Address - Phone:808-442-5700
Mailing Address - Fax:855-827-2321
Practice Address - Street 1:85 MAUI LANI PKWY
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-2416
Practice Address - Country:US
Practice Address - Phone:808-442-5700
Practice Address - Fax:855-827-2321
Is Sole Proprietor?:No
Enumeration Date:2006-04-08
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV22033207RC0000X, 207RI0011X
VA0101237735207RC0000X, 207RI0011X
HI23299207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV9332051OtherWV MEDICARE GRP-OLD
VA010186099Medicaid
176481OtherANTHEM PROFESSIONAL
WV3810003816Medicaid
VAP00844458OtherRR MEDICARE
001727254OtherWV BLUE SHIELD
WV3810003817OtherWV MEDICAID GROUP
94909OtherSENTARA PROFESSIONAL
2131008OtherMAMSI PROFESSIONAL
MD550941600OtherMD MEDICAID GROUP
MD412140600Medicaid
WV000875693OtherWV BLUE SHIELD GROUP
WV9371521OtherWV MEDICARE GRP-NEW
C00085OtherVA MEDICARE B - GROUP #
WV000875693OtherWV BLUE SHIELD GROUP
2131008OtherMAMSI PROFESSIONAL
VA010186099Medicaid
VA007674W85Medicare PIN