71-1409 MAMALOHOA HWY
KAILUAKONA, HI 96740 US PECOS Enrolled
Overview
Patricia Carol Patrick is a Psychiatrist in the KAILUAKONA area and has over 61 years of experience. Patricia Carol Patrick primary office location is at 71-1409 MAMALOHOA HWY and new patients are welcome to contact this healthcare provider for an appointment. She attended Northwestern University Feinberg Medical School and graduated 1963 The NPI number is 1205850617 and the information was updated approximately 17 years ago.
We have not detected any Exclusions tied directly to this NPI.
Accepts Medicare Assignment: Unknown
Is sole proprietor: NO
Participates in PECOS: YES (See any PECOS details below)
Contact Information
| License Number | State |
|---|---|
| 10801 | HI |
| 1231 | AK |
| Type/Issuer | Identifier | State |
|---|---|---|
| QUEST | 0000238634 | HI |
| HMSA | 238634 | HI |
| MEDICAID | 5292408 | HI |
| Taxonomy | State | Primary? |
|---|---|---|
| Psychiatrist - Taxonomy Code 2084P0800X | HI | Y |
| Psychiatrist - Taxonomy Code 2084P0800X | AK | N |
PECOS Details:
| Participates in PECOS: | YES |
| PECOS Individual Enrollment ID: | I20060412000084 |
| PECOS Individual PAC ID: | 1951376938 |
| Eligible to order/refer Part B Clinical Laboratory and Imaging | - |
| Eligible to order/refer Durable Medical Equipment (DME) | Yes |
| Eligible to order/refer Home Health Agency (HHA) | - |
| Eligible to order/refer Power Mobility Devices (PMD) | Yes |
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