Individual provider Active NPI

Godofredo Barcena Baclig, M.D.

  • Internal Medicine Physician
  • Honolulu, HI
National Provider Identifier
1114010709
Registry record updated Feb 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
8967 Issued in HI
Practice address
405 N Kuakini St
Suite 1112
Honolulu, HI 96817-6300
Phone
(808) 524-5024
Fax
(808) 524-5715
NPI assigned
Oct 2, 2006
Last updated
Feb 8, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 8967 HI Primary

Addresses

Primary practice location

405 N Kuakini St
Suite 1112
Honolulu, HI 96817-6300

Mailing address

405 N Kuakini St
Suite 1112
Honolulu, HI 96817-6300
Phone (808) 524-5024

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
I20060113000019 HI Practitioner - Internal Medicine 9335162551 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

405 N Kuakini St
Suite 1112
Honolulu, HI 96817-6301

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8967HIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Godofredo B. Baclig, M.D. Inc. CurrentSince Jan 8, 2013 Accepting new patients

Locations

405 N Kuakini St
Ste 1112
Honolulu, HI 96817
Phone (808) 524-5024

Networks

  • HI PPO
  • devoted network organization-c89d4c14-e90f-4cf7-83f9-456527a52335

Interoperability endpoints

  • Direct secure messaging: godofredo.baclig@43149963362308.direct.elationemr.com

Organizations & group practices 1

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 5

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360281600000",
    "number": "1114010709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 N KUAKINI ST",
            "address_2": "SUITE 1112",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968176300",
            "telephone_number": "808-524-5024",
            "fax_number": "808-524-5715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 N KUAKINI ST",
            "address_2": "SUITE 1112",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968176300",
            "telephone_number": "808-524-5024",
            "fax_number": "808-524-5715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACLIG",
        "first_name": "GODOFREDO",
        "middle_name": "BARCENA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2013-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "8967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.