Brent Koichi Tamamoto, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD 14517 Issued in HI

Practice address

99-080 Kauhale St
Suite C-22
Aiea, HI 96701-4114

Phone

(808) 487-1600

Fax

(808) 487-1601

NPI assigned

Jun 26, 2007

Last updated

Dec 30, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Aiea Pediatrics, LLC

  • Pediatrics Physician
  • Aiea, HI
  • NPI 1407089808
  NPD (past) Authorized official
• Hawaii Permanente Medical Group Inc

  • Health Maintenance Organization
  • Honolulu, HI
  • NPI 1710945969
  NPD (past)
• Pacific Training Program

  • Pediatrics Physician
  • Aiea, HI
  • NPI 1407963606
  NPD (past)

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388361600000",
    "number": "1114123098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99-080 KAUHALE ST",
            "address_2": "SUITE C-22",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967014114",
            "telephone_number": "808-487-1600",
            "fax_number": "808-487-1601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99-080 KAUHALE ST",
            "address_2": "SUITE C-22",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967014114",
            "telephone_number": "808-487-1600",
            "fax_number": "808-487-1601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAMAMOTO",
        "first_name": "BRENT",
        "middle_name": "KOICHI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-26",
        "last_updated": "2013-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "HI",
            "license": "MD 14517",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "618043",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sherrie M. Takushi-Isara, PSY.D.
• Miki Takushi, LMHC
• Tiffany Takushi
• Laverne Tamai, MS, CCC-SLP
• Alyson Tamamoto, MD
• Alan M. Tamashiro, D.D.S.
• Wayne Masao Tamashiro, D. D. S.
• Ruby Tamayo
• Bryan Shunzo Tamura, DDS
• Peter Tamura, MD

• Pediatrics Physician in Aiea, HI
• Providers in Aiea, HI by specialty
• Pediatrics Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.