Organization Active NPI

Carly Wachi LLC

  • Anesthesiology Physician
  • Honolulu, HI
National Provider Identifier
1003522350
Registry record updated Jan 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
CARLY WACHI LLC
Practice address
4348 Waialae Avenue # 788
Honolulu, HI 96816-5767
Phone
(808) 554-5470
NPI assigned
Jan 30, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Carly Akemi Wachi, M.D.NPI 1841646312
Title
Member
Phone
(808) 554-5470

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

4348 Waialae Avenue # 788
Honolulu, HI 96816-5767

Mailing address

4348 Waialae Avenue # 788
Honolulu, HI 96816-5767
Phone (808) 554-5470

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230427000400 HI Part B Supplier - Clinic/Group Practice 7315302353 Receives reassigned benefits from 1 practitioner
Practice locations: Honolulu, HI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1675036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675036800000",
    "number": "1003522350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4348 WAIALAE AVENUE # 788",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968165767",
            "telephone_number": "808-554-5470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4348 WAIALAE AVENUE # 788",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968165767",
            "telephone_number": "808-554-5470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLY WACHI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-30",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-23",
        "status": "A",
        "authorized_official_last_name": "WACHI",
        "authorized_official_first_name": "CARLY",
        "authorized_official_middle_name": "AKEMI",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "808-554-5470",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.