NPIMap

Organization Active NPI

State of Hawaii Department of Health

Doing business as Puna Clinic

  • Community/Behavioral Health Agency
  • Pahoa, HI
National Provider Identifier
1083897979
Registry record updated Jun 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
STATE OF HAWAII DEPARTMENT OF HEALTH
Doing business as
Puna Clinic
Practice address
15-2866 Govt. Road Pahoa Town Center
BLDG. E
Pahoa, HI 96778
Phone
(808) 965-2240
NPI assigned
Dec 13, 2007
Last updated
Jun 19, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
STATE OF HAWAII DEPARTMENT OF HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 19, 2014

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

Authorized official

Name
Raquel B. Nakahara
Title
Financial Resource Specialist
Phone
(808) 590-7320

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

15-2866 Govt. Road Pahoa Town Center
BLDG. E
Pahoa, HI 96778

Mailing address

1250 Punchbowl St
RM 256
Honolulu, HI 96813-2416
Phone (808) 590-7320

Other identifiers 1

IdentifierTypeStateIssuer
53937217MedicaidHI

Other names 1

  • Puna Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040127000902 HI Part B Supplier - Clinic/Group Practice 5395648539 Receives reassigned benefits from 23 practitioners
23 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kealakekua, HI; Lahaina, HI; Lanai City, HI; Kaneohe, HI; Lihue, HI; Naalehu, HI; Pahoa, HI; Pearl City, HI…

Other NPIs on the same Medicare enrollment 23

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 23

National Provider Directory

National Provider Directory
Tax ID family
Central Oahu Comm Menta103 organizations share this tax ID, including this one
Part of
Central Oahu Comm Menta

Organizations with this tax ID in the same state 14

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 14

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1197504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403136000000",
    "number": "1083897979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 PUNCHBOWL ST",
            "address_2": "RM 256",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132416",
            "telephone_number": "808-590-7320",
            "fax_number": "808-586-4745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15-2866 GOVT. ROAD PAHOA TOWN CENTER",
            "address_2": "BLDG. E",
            "city": "PAHOA",
            "state": "HI",
            "postal_code": "96778",
            "telephone_number": "808-965-2240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF HAWAII DEPARTMENT OF HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STATE OF HAWAII DEPARTMENT OF HEALTH",
        "enumeration_date": "2007-12-13",
        "last_updated": "2014-06-19",
        "status": "A",
        "authorized_official_last_name": "NAKAHARA",
        "authorized_official_first_name": "RAQUEL",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "FINANCIAL RESOURCE SPECIALIST",
        "authorized_official_telephone_number": "808-590-7320"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "53937217",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Puna Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pahoa, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.