Active NPI
Patricia Podach, M.D.
- Legal Medicine
- Wailuku, HI
National Provider Identifier
1275683641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Legal Medicine
- License
- MD12325
- Practice address
- 1881 Nani St
Wailuku, HI 96793-1811 - Phone
- (808) 871-7772
- Fax
- (808) 872-4029
- NPI assigned
- Jan 10, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Legal Medicine | 173000000X | MD12325 | HI | Primary |
Addresses
Primary practice location
1881 Nani St
Wailuku, HI 96793-1811
Mailing address
1881 Nani St
Wailuku, HI 96793-1811
Phone (808) 871-7772
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 071290-05 | Medicaid | HI |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD12325 | HI | MD | Legal Medicine |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gibson Community Hospital Association | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Critical Access Hospital
- Gibson City, IL
- NPI 1114935681
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1270771200000",
"number": "1275683641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1881 NANI ST",
"city": "WAILUKU",
"state": "HI",
"postal_code": "967931811",
"telephone_number": "808-871-7772",
"fax_number": "808-872-4029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1881 NANI ST",
"city": "WAILUKU",
"state": "HI",
"postal_code": "967931811",
"telephone_number": "808-871-7772",
"fax_number": "808-872-4029"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PODACH",
"first_name": "PATRICIA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-10",
"last_updated": "2010-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "173000000X",
"taxonomy_group": "",
"desc": "Legal Medicine",
"state": "HI",
"license": "MD12325",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "071290-05",
"state": "HI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wailuku, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.