Individual provider Active NPI

Gaku Yamaguchi, M.D.

  • Family Medicine Physician
  • Hilo, HI
National Provider Identifier
1033592126
Registry record updated Dec 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD-19597 Issued in HI
Practice address
1438 Kilauea Ave
Hilo, HI 96720-4286
Phone
(808) 969-9220
NPI assigned
Jul 7, 2015
Last updated
Dec 19, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD-19597 HI Primary

Addresses

Primary practice location

1438 Kilauea Ave
Hilo, HI 96720-4286

Mailing address

1438 Kilauea Ave
Hilo, HI 96720-4286
Phone (808) 969-9220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190125001751 HI Practitioner - Family Practice 0941547137 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hui Malama Ola NA OiwiGroup PAC ID 3274559265, 4 clinicians

Practice addresses (Care Compare)

1438 Kilauea Ave
Hilo, HI 96720-4286
Phone (808) 969-9220

82 Puuhonu PL
Suite 209
Hilo, HI 96720-2010
Phone (808) 796-3125

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD-19597HIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hui Malama Ola NA 'Oiwi CurrentSince Dec 20, 2018 Accepting new patients
Randall H. Hirata M.D., Inc. PastSince Jul 24, 2022 Accepting new patients

Locations

82 Puuhonu Pl
Ste 209
Hilo, HI 96720
Phone (808) 796-3125

1438 Kilauea Ave
Hilo, HI 96720
Phone (808) 796-3125

Networks

  • HI PPO

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AAJCBD/Endpoint/AAJCBD
  • FHIR API: https://fhir4.healow.com/fhir/r4/AAJCBD
  • Direct secure messaging: gaku.yamaguchi@hawaiihie.medicity.net

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1436227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545177600000",
    "number": "1033592126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1438 KILAUEA AVE",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967204286",
            "telephone_number": "808-969-9220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1438 KILAUEA AVE",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967204286",
            "telephone_number": "808-969-9220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAMAGUCHI",
        "first_name": "GAKU",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-07",
        "last_updated": "2018-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "HI",
            "license": "MD-19597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilo, HI

Sources for this page

Verify at the official NPI Registry.