MEDICARE: DR. MIYASAKA OPTOMETRY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist

General Provider Information

NPI Number	:	1992470421
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. MIYASAKA OPTOMETRY, LLC

Provider Business Mailing Address
First Line	:	3615 HARDING AVE STE 208
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96816-3760
Country	:	US
Telephone Number	:	801-845-2677
Fax Number	:	808-800-3222

Provider Business Practice Location Address
First Line	:	68-1820 WAIKOLOA RD STE 305
Second Line	:
City	:	WAIKOLOA
State	:	HI
Zip	:	96738-5597
Country	:	US
Telephone Number	:	808-315-7020
Fax Number	:

Authorized Official
Title or Position	:	OPTOMETRIST/BUSINESS OWNER
Name	:	DR. JAMES K MIYASAKA
Credential	:	OD
Telephone Number	:	808-782-8546

Provider Enumeration Date	:	08/16/2021
Last Update Date	:	02/15/2026

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