Active NPI
Michael R. Palmerston Jr., BA
- Health Maintenance Organization
- Hilo, HI
National Provider Identifier
1083945265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Maintenance Organization
- License
- 305R00000X
- Practice address
- 77 Mohouli St
Hilo, HI 96720-4181 - Phone
- (808) 961-5166
- Fax
- (808) 934-0071
- NPI assigned
- Jan 27, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Exclusive Provider Organization | 302F00000X | 302F00000X | HI | |
| Health Maintenance Organization | 302R00000X | 305R00000X | HI | Primary |
Addresses
Primary practice location
77 Mohouli St
Hilo, HI 96720-4181
Mailing address
72 Anuenue St
Hilo, HI 96720-9734
Phone (808) 969-3488
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 302F00000X | HI | MD | Exclusive Provider Organization |
| 305R00000X | HI | MD | Health Maintenance Organization |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1264550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264550400000",
"number": "1083945265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "72 ANUENUE ST",
"city": "HILO",
"state": "HI",
"postal_code": "967209734",
"telephone_number": "808-969-3488",
"fax_number": "808-934-0071"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "77 MOHOULI ST",
"city": "HILO",
"state": "HI",
"postal_code": "967204181",
"telephone_number": "808-961-5166",
"fax_number": "808-934-0071"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALMERSTON",
"first_name": "MICHAEL",
"middle_name": "R.",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "BA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-01-27",
"last_updated": "2010-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "302F00000X",
"taxonomy_group": "",
"desc": "Exclusive Provider Organization",
"state": "HI",
"license": "302F00000X",
"primary": false
},
{
"code": "302R00000X",
"taxonomy_group": "",
"desc": "Health Maintenance Organization",
"state": "HI",
"license": "305R00000X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hilo, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.