Active NPI
Tyrie Lee Jenkins, M.D., Inc.
- Specialist
- Honolulu, HI
National Provider Identifier
1295791135
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MD5046
- Legal business name
- TYRIE LEE JENKINS, M.D., INC.
- Practice address
- 615 Piikoi St
Suite 205
Honolulu, HI 96814-3116 - Phone
- (808) 591-9911
- Fax
- (808) 591-9909
- NPI assigned
- Apr 20, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tyrie Lee Jenkins, M.D.
- Title
- President
- Phone
- (808) 591-9911
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MD5046 | HI | Primary |
Addresses
Primary practice location
615 Piikoi St
Suite 205
Honolulu, HI 96814-3116
Mailing address
615 Piikoi St
Suite 205
Honolulu, HI 96814-3116
Phone (808) 591-9911
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 056891-01 | Medicaid | HI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in HI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040320000599 | HI | Part B Supplier - Clinic/Group Practice | 4183515265 |
Receives reassigned benefits from 5 practitioners Practice locations: Honolulu, HI; Makawao, HI |
National Provider Directory
National Provider DirectoryLocations
615 Piikoi St
Ste 205
Honolulu, HI 96814
Phone (808) 591-9911
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145491200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1756166400000",
"number": "1295791135",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 PIIKOI ST",
"address_2": "SUITE 205",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968143116",
"telephone_number": "808-591-9911",
"fax_number": "808-591-9909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 PIIKOI ST",
"address_2": "SUITE 205",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968143116",
"telephone_number": "808-591-9911",
"fax_number": "808-591-9909"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TYRIE LEE JENKINS, M.D., INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-04-20",
"last_updated": "2025-08-26",
"certification_date": "2025-08-26",
"status": "A",
"authorized_official_last_name": "JENKINS",
"authorized_official_first_name": "TYRIE",
"authorized_official_middle_name": "LEE",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "808-591-9911",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist",
"state": "HI",
"license": "MD5046",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "056891-01",
"state": "HI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Honolulu, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.