Venture Medical 21 Inc - Medicare Primary Care in Ewa Beach, HI

Venture Medical 21 Inc is a medicare enrolled primary clinic (Clinic/center) in Ewa Beach, Hawaii. The current practice location for Venture Medical 21 Inc is 91-896 Makule Rd Ste 102, Ewa Beach, Hawaii. For appointments, you can reach them via phone at (808) 689-4414. The mailing address for Venture Medical 21 Inc is 810 Richards St Ste 990, Honolulu, Hawaii and phone number is (808) 531-7878.

Venture Medical 21 Inc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1851647952. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (808) 689-4414.

Contact Information

Venture Medical 21 Inc
91-896 Makule Rd Ste 102
Ewa Beach
HI 96706-2543
(808) 689-4414
(808) 689-7115

Primary Care Clinic Profile

Full NameVenture Medical 21 Inc
SpecialityClinic/Center
Location91-896 Makule Rd Ste 102, Ewa Beach, Hawaii
Authorized Official Name and PositionJose D Reque (PRESIDENT)
Authorized Official Contact8085317878
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Venture Medical 21 Inc
810 Richards St Ste 990
Honolulu
HI 96813-4722

Ph: (808) 531-7878
Venture Medical 21 Inc
91-896 Makule Rd Ste 102
Ewa Beach
HI 96706-2543

Ph: (808) 689-4414

NPI Details:

NPI Number1851647952
Provider Enumeration Date07/26/2012
Last Update Date08/15/2014

Medicare PECOS Information:

Medicare PECOS PAC ID7810147832
Medicare Enrollment IDO20121026000580

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Medical Identifiers

Medical identifiers for Venture Medical 21 Inc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1851647952NPI-NPPES
W8141213401OtherHISTATE OF HAWAII

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261Q00000XClinic/center (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Venture Medical 21 Inc acts as a billing entity for following providers:
Provider NameJose C De Leon
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1275639866
PECOS PAC ID: 3870519036
Enrollment ID: I20051018000569

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Provider NameMacrina U Vicerra-jaena
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1992758015
PECOS PAC ID: 0547410490
Enrollment ID: I20121030000447

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Provider NameJacqueline Y Chacon
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1023376779
PECOS PAC ID: 5799936076
Enrollment ID: I20121114000299

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