Brenda M.K. Camacho M.D. LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

MD9518 Issued in HI

Legal business name

BRENDA M.K. CAMACHO M.D. LLC

Practice address

615 Ponahawai St Ste 201
Hilo, HI 96720-7665

Phone

(808) 935-1621

Fax

(808) 935-5959

NPI assigned

Jan 4, 2011

Last updated

Apr 18, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brenda Michiko Camacho, M.D.NPI 1255407995

Title

Physician

Phone

(808) 935-1621

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in HI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brenda M K Camacho, MD

  • Pediatrics Physician
  • Hilo, HI
  • NPI 1255407995
  Medicare reassignment NPD Authorized official
• Allison Mieko Ohta, APRN

  • Family Nurse Practitioner
  • Hilo, HI
  • NPI 1730968314
  NPD
• Ty Jordan Tsuji De Silva, M.D.

  • Pediatrics Physician
  • Hilo, HI
  • NPI 1588860787
  NPD (past)

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

{
    "created_epoch": "1294099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713398400000",
    "number": "1467756536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 PONAHAWAI ST",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967207665",
            "telephone_number": "808-935-1621",
            "fax_number": "808-935-5959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 PONAHAWAI ST STE 201",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967207665",
            "telephone_number": "808-935-1621",
            "fax_number": "808-935-5959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRENDA M.K. CAMACHO M.D. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-04",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A",
        "authorized_official_last_name": "CAMACHO",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "MICHIKO",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "808-935-1621",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "HI",
            "license": "MD9518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002084-02",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lourdes Bowman
• Deborah Boyer
• Katina Brantley
• Joseph C. Bratton, PH.D.
• Michele Braun
• Mathan Brewer
• Micah Jared Brewer, LAC, MAT
• Brian Wilson MD L.L.C.
• Brighter Days Counseling LLC
• Brighton Rehabilitation LLC

• Clinic/Center in Hilo, HI
• Providers in Hilo, HI by specialty
• Clinic/Center in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.