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DR. RUSSELL G TACATA M.D.
NPI 1356341002
General Practice in Honolulu, HI

Active since July 22, 2005PECOS EnrolledAccepts Medicare AssignmentCLIA 12D0944192 · Waiver
1619 LILIHA STREET, #3, HONOLULU, HI 96817(808) 531-5454(808) 531-5451 Get Directions Write a Review

NPPES record last updated: August 3, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Russell G Tacata M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. RUSSELL G TACATA M.D. (NPI 1356341002) is an individual general practice provider in Honolulu, Hawaii, licensed in Hawaii (9570) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS, holds a CLIA Waiver certificate valid through April 7, 2028, and is affiliated with The Queens Medical Center.

NPPES Registry Identity

NPI1356341002
Entity TypeIndividualMale
Primary Taxonomy208D00000X
Provider Legal NameDR. RUSSELL G TACATACredential: M.D.
Location Address1619 LILIHA STREET, #3Honolulu, HI 96817-3152
Mailing Address1619 Liliha Street, #3Honolulu, HI 96817-3152 · (808) 531-5454 · Fax (808) 531-5451
Phone(808) 531-5454
Fax(808) 531-5451
Sole ProprietorNo
Medical School CMSOtherGraduated 1982
Enumeration DateJuly 22, 2005
Last NPPES UpdateAugust 3, 2023
NPPES CertifiedAugust 3, 2023
✔ NPI 1356341002 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in HI · 9570
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
1619 LILIHA STREET, Honolulu, HI 96817
Open in Google Maps ↗

Other Identifiers 2

Medicaid07892401HI
Other020779-5Hmsa

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HMSA.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Russell G Tacata M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2567485550
PECOS Enrollment IDI20060105000043
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 12D0944192

Russell G Tacata Medical Clinic · Honolulu, HI
Active · expires Apr 7, 2028
CLIA Number12D0944192
Laboratory TypePhysician Office
Certificate Effective DateApril 8, 2026
Certificate Expiration DateApril 7, 2028
Laboratory DirectorRussell G. Tacata
Laboratory Phone(808) 531-5454
Laboratory LocationRussell G Tacata Medical Clinic1619 Liliha St Ste #3, Honolulu, HI 96817
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
133 services47 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
83 services51 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
27 services27 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

The Queens Medical Center

Acute Care Hospitals · Honolulu, HI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number120001
Location1301 Punchbowl StHonolulu, HI 96813 · Honolulu County
Emergency services Birthing friendly

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
5 suppliers14 claims21 services$6.58 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Russell Tacata's NPI number?

The NPI number for Russell Tacata is 1356341002. It was assigned to this individual provider in the NPPES registry on July 22, 2005.

Where is Russell Tacata located?

Russell Tacata practices at 1619 Liliha Street #3, Honolulu, HI 96817. The listed phone number is (808) 531-5454.

What is Russell Tacata's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Russell Tacata enrolled in Medicare?

Yes. Russell Tacata is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Does Russell Tacata hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 12D0944192) is associated with this NPI, valid through April 7, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Russell Tacata accept?

Health plans from HMSA list Russell Tacata as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Russell Tacata affiliated with any hospitals?

According to CMS data, Russell Tacata is affiliated with The Queens Medical Center.

When was this NPI record last updated?

The NPPES record for Russell Tacata was last updated on August 3, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.