Individual provider Active NPI

Raechel Pacheco, M.D.

  • Family Medicine Physician
  • Kapolei, HI
National Provider Identifier
1902959000
Registry record updated Nov 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD-17605 Issued in HI
Practice address
91-1227 Enterprise Ave
Kapolei, HI 96707-2150
Phone
(080) 672-1678
Fax
(808) 278-5659
NPI assigned
Jan 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD2009-0763 NM
Family Medicine Physician 207Q00000X RS2006-0356 NM
Family Medicine Physician 207Q00000X MD-17605 HI Primary

Addresses

Primary practice location

91-1227 Enterprise Ave
Kapolei, HI 96707-2150

Mailing address

91-729 Launahele St
Ewa Beach, HI 96706-4756
Phone (808) 554-7990

Other practice location 1

1 Jarrett White Rd
Tripler Amc, HI 96859-5001
Phone (808) 433-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-17605HIMDFamily Medicine Physician
MD2009-0763NMMDFamily Medicine Physician
RS2006-0356NMMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669075200000",
    "number": "1902959000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91-729 LAUNAHELE ST",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967064756",
            "telephone_number": "808-554-7990",
            "fax_number": "808-278-5659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91-1227 ENTERPRISE AVE",
            "city": "KAPOLEI",
            "state": "HI",
            "postal_code": "967072150",
            "telephone_number": "080-672-1678",
            "fax_number": "808-278-5659"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Jarrett White Rd",
            "address_purpose": "LOCATION",
            "city": "Tripler Amc",
            "state": "HI",
            "postal_code": "968595001",
            "country_code": "US",
            "telephone_number": "808-433-5000",
            "fax_number": "808-278-5659",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PACHECO",
        "first_name": "RAECHEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "MD2009-0763",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "RS2006-0356",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "HI",
            "license": "MD-17605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kapolei, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.