Individual provider Active NPI

Peter Y Yamamoto, M.D.

  • Psychiatry Physician
  • Waianae, HI
National Provider Identifier
1386796589
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD-12004 Issued in HI
Practice address
86-226 Farrington Hwy
Waianae, HI 96792-3128
Phone
(808) 696-4211
Fax
(808) 696-5516
NPI assigned
Jan 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD-12004 HI Primary

Addresses

Primary practice location

86-226 Farrington Hwy
Waianae, HI 96792-3128

Mailing address

86-226 Farrington Hwy
Waianae, HI 96792-3128
Phone (808) 696-4211

Other identifiers 3

IdentifierTypeStateIssuer
0053794601MedicaidHI
0000240929OtherHIHMSA
0053794600OtherHIALOHA CARE

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
I20090504000581 HI Practitioner - PsychiatryPractitioner - Addiction Medicine 1759439581 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Addiction Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Alcoholic Rehabilitation Services of Hawaii IncGroup PAC ID 8426216466, 2 clinicians

Practice addresses (Care Compare)

45 -845 Pookela St
Kaneohe, HI 96744-5700
Phone (808) 236-2600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-12004HIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of Hawaii Department of Health Psychiatry Past Accepting new patients
Heather H. McDermott, Psy.D., LLC PastSince Feb 20, 2016 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1386796589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86-226 FARRINGTON HWY",
            "city": "WAIANAE",
            "state": "HI",
            "postal_code": "967923128",
            "telephone_number": "808-696-4211",
            "fax_number": "808-696-5516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86-226 FARRINGTON HWY",
            "city": "WAIANAE",
            "state": "HI",
            "postal_code": "967923128",
            "telephone_number": "808-696-4211",
            "fax_number": "808-696-5516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAMAMOTO",
        "first_name": "PETER",
        "middle_name": "Y",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "HI",
            "license": "MD-12004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0053794601",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "0000240929",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALOHA CARE",
            "identifier": "0053794600",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waianae, HI

Sources for this page

Verify at the official NPI Registry.