Rodrigo G Bristol, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

2213 Issued in HI

Practice address

634 Kalihi St
Honolulu, HI 96819

Phone

(808) 845-3911

Fax

(808) 868-0870

NPI assigned

Oct 19, 2006

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811079924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "634 KALIHI ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "96819",
            "telephone_number": "808-845-3911",
            "fax_number": "808-868-0870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "634 KALIHI ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "96819",
            "telephone_number": "808-845-3911",
            "fax_number": "808-868-0870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRISTOL",
        "first_name": "RODRIGO",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "HI",
            "license": "2213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "0000036103",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03263601",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan James Brimley
• Teresa Louise Brink Wong, RN CDE
• Alexis Pua Lani Lee Brissette, RN
• Bristol Hospice - Hawaii, LLC
• Bristol Rehab LLC
• Ryan G Bristol, P.T.
• Janet Brito, PSY
• Alexandra Elaine Britt, MS, RD, LDN
• Debra J Brittain, CRNA
• Alan Britten, M.D.

• 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 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.