Russell G Tacata, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

9570 Issued in HI

Practice address

1619 Liliha Street
#3
Honolulu, HI 96817-3152

Phone

(808) 531-5454

Fax

(808) 531-5451

NPI assigned

Jul 22, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

General Practice

Education

Other, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bayada Home Health Care Home health agency, Honolulu, HI, CCN 127310
• The Queens Medical Center Hospital, Honolulu, HI, CCN 120001

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: russell.tacata@39580522708996.direct.elationemr.com

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.

• Russell G Tacata MD

  • Clinic/Center
  • Honolulu, HI
  • NPI 1831872126
  Authorized official Same address or phone
• Healthcare Therapy Clinic

  • Physical Therapy Clinic/Center
  • Honolulu, HI
  • NPI 1467529743
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• B. C. P., Inc.

  dba BAYADA Home Health Care, Inc.

  • Home Health Agency
  • Honolulu, HI
  • NPI 1306105176
  Care Compare affiliation
• B.C.P., Inc.

  dba BAYADA Home Health Care

  • Home Health Agency
  • Honolulu, HI
  • NPI 1225478605
  Care Compare affiliation
• The Queens Medical Center

  • General Acute Care Hospital
  • Honolulu, HI
  • NPI 1184612764
  Care Compare affiliation

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

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691020800000",
    "number": "1356341002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1619 LILIHA STREET",
            "address_2": "#3",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968173152",
            "telephone_number": "808-531-5454",
            "fax_number": "808-531-5451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1619 LILIHA STREET",
            "address_2": "#3",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968173152",
            "telephone_number": "808-531-5454",
            "fax_number": "808-531-5451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACATA",
        "first_name": "RUSSELL",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-22",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "HI",
            "license": "9570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07892401",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "020779-5",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jenalene Tabbay, LMHC
• Eludrizza Tabisola-Nuesca
• Christopher Tabor, RBT
• Stacey-Joy Medina Tabucbuc
• Rachel Haide Naraval Tacata, MD
• Andrea Tachella
• Naomi Tachera
• Yukako Tachibana, M.D.
• Loren Tacker
• Bert Chiyotano Tada, PT

• General Practice Physician in Honolulu, HI
• Providers in Honolulu, HI by specialty
• General Practice Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.