Tracey Yamamoto-Kubo, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD-376 Issued in HI

Practice address

915 N King St
Honolulu, HI 96817-4544

Phone

(808) 845-0686

Fax

(808) 845-0798

NPI assigned

Aug 20, 2006

Sex

Female

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Pacific University - College of Optometry, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kalihi Palama Health CenterGroup PAC ID 4284544842, 28 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tracey.yamamoto-kubo.1@28780.direct.athenahealth.com

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.

• Kalihi Palama Health Center

  • Federally Qualified Health Center (FQHC)
  • Honolulu, HI
  • NPI 1457304966
  Medicare reassignment Care Compare group NPD
• Kalihi Palama Health Center

  • Federally Qualified Health Center (FQHC)
  • Honolulu, HI
  • NPI 1235908831
  NPD
• Kalihi Palama Health Center

  • Federally Qualified Health Center (FQHC)
  • Honolulu, HI
  • NPI 1881632156
  NPD

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437264348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 N KING ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968174544",
            "telephone_number": "808-845-0686",
            "fax_number": "808-845-0798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 N KING ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968174544",
            "telephone_number": "808-845-0686",
            "fax_number": "808-845-0798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAMAMOTO-KUBO",
        "first_name": "TRACEY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "HI",
            "license": "OD-376",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0000213074",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0051863109",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jon Steven Yamaguchi, MD
• Karen C. Yamaguchi, DPM
• Kelli Yamaguchi, NP
• Megan Katsuko Yamaguchi
• Sayumi Yamaguchi, LMT
• Noela Yamamoto-Valdez, PSY.D.
• Anna Katrina Yamamoto, REGISTERED NURSE
• Annie Chao-an Yung Yamamoto
• Charlene L. Yamamoto, LCSW
• Chris Keiji Yamamoto, O.D.

• Optometrist in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Optometrist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.