NPIMap

Organization Active NPI

Waikiki Health

  • Federally Qualified Health Center (FQHC)
  • Honolulu, HI
National Provider Identifier
1093156119
Registry record updated Dec 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
WAIKIKI HEALTH
Practice address
935 Makahiki Way
Honolulu, HI 96826-2896
Phone
(808) 922-4787
NPI assigned
Jul 17, 2013
Last updated
Dec 6, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2013

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

Authorized official

Name
Sheila Beckham, RD, MPH
Title
Ceo
Phone
(808) 791-9302

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

935 Makahiki Way
Honolulu, HI 96826-2896

Mailing address

277 Ohua Ave
Honolulu, HI 96815-6612
Phone (808) 922-4787

Other names 1

  • Waikiki Health Makahiki Clinic Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040521000013 HI Part B Supplier - Clinic/Group Practice 9335058536 Receives reassigned benefits from 49 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Honolulu, HI
O20131029001769 HI Part A Provider - Federally Qualified Health Center (FQHC) 9335058536 Practice locations: Honolulu, HI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1093156119. Details of each certification follow.

Federally qualified health center certification: CCN 121850

Legal name
WAIKIKI HEALTH
Doing business as
WAIKIKI HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 13, 2013
Last certification
Nov 13, 2013
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Dec 12, 1971 in HI
Enrollment address
935 Makahiki Way
Honolulu, HI 96826-2896

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory

Locations

415 Keoniana St
Honolulu, HI 96815
Phone (808) 942-5858

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Elliot J Kalauawa Individual Corporate OfficerChief Medical Officer Sep 19, 2011
Alexis Charpentier Individual Corporate OfficerChief Executive Officer Feb 16, 2024
W-2 Managing EmployeeChief Executive Officer Feb 16, 2024 100%
Waikiki Health Organization, Honolulu, HI Operational/Managerial Control Jul 10, 2013 100%
Yumiko Molden Individual Corporate Officer Jul 17, 2024

Owners & managing parties with NPI records 5

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 11

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": "1374019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386288000000",
    "number": "1093156119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "277 OHUA AVE",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968156612",
            "telephone_number": "808-922-4787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 MAKAHIKI WAY",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968262896",
            "telephone_number": "808-922-4787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAIKIKI HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-17",
        "last_updated": "2013-12-06",
        "status": "A",
        "authorized_official_last_name": "BECKHAM",
        "authorized_official_first_name": "SHEILA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "808-791-9302",
        "authorized_official_credential": "RD, MPH"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Waikiki Health Makahiki Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.