Bay Clinic Pharmacy – Federally Qualified Health Center (FQHC), NPI 1104874619
Federally Qualified Health Center (FQHC)
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Bay Clinic Pharmacy
75-5751 KUAKINI HWY STE 203
KAILUA KONA, HI 967401753
Phone: (808) 326-5629
Type: Mailing
Pili Mua Street, Keaʻau, Hawaiʻi County, Hawaii, United States
KEAAU, HI 967498134
Phone: (808) 930-0400
Fax: (808) 961-5678
Type: Location
450, Kilauea Avenue, Waiākea, Hilo, Hawaiʻi County, Hawaii, 96720, United States
STE 105
HILO, HI 967203089
Phone: (808) 961-4071
Fax: (808) 961-5678
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2023-10-06
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Revalidation due soon
Earliest CMS due date is 2026-07-31 (46 days away).
Enrollment records
2
Earliest due date
2026-07-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20031120000512 | O | Clinic/Group Practice | HI | 2026-07-31 |
| O20231006002198 | O | Federally Qualified Health Center (Fqhc) | HI | TBD |
What to do next
- Confirm the due date on the CMS Revalidation Lookup Tool.
- Complete revalidation in PECOS before the published due date.
- If you have multiple enrollment records, revalidate each one on its own schedule.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 96740)
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