NPIMap

Organization Active NPI

Kaiser Foundation Health Plan

Doing business as Kaiser Permanente Mapunapuna Clinic Ambulatory Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Honolulu, HI
National Provider Identifier
1093881641
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
FSOF-8 Issued in HI
Legal business name
KAISER FOUNDATION HEALTH PLAN
Doing business as
Kaiser Permanente Mapunapuna Clinic Ambulatory Surgery Center
Practice address
2828 Paa St
Honolulu, HI 96819-4430
Phone
(808) 432-5738
Fax
(808) 432-5730
NPI assigned
Nov 27, 2006
Last updated
Nov 10, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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

Authorized official

Name
James G. Adams Jr.
Title
Executive Director, Finance Leader
Phone
(808) 286-6758

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X FSOF-8 HI Primary

Addresses

Primary practice location

2828 Paa St
Honolulu, HI 96819-4430

Mailing address

711 Kapiolani Blvd
Billing Department
Honolulu, HI 96813-5214
Phone (808) 432-5312

Other identifiers 1

IdentifierTypeStateIssuer
588783MedicaidHI

Other names 1

  • Kaiser Permanente Mapunapuna Clinic Ambulatory Surgery Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040831000706 HI Part B Supplier - Ambulatory Surgical Center 1850205360 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Honolulu, HI; Wailuku, HI

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Kaiser Permanente Honolulu Clinic ASCCCN 12C0001012
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Kaiser Foundation HLTH379 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604966400000",
    "number": "1093881641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 KAPIOLANI BLVD",
            "address_2": "BILLING DEPARTMENT",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968135214",
            "telephone_number": "808-432-5312",
            "fax_number": "808-432-5239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2828 PAA ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968194430",
            "telephone_number": "808-432-5738",
            "fax_number": "808-432-5730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER FOUNDATION HEALTH PLAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-27",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR, FINANCE LEADER",
        "authorized_official_telephone_number": "808-286-6758",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "HI",
            "license": "FSOF-8",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "588783",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kaiser Permanente Mapunapuna Clinic Ambulatory Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kaiser Permanente Mapunapuna Clinic Ambulatory Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.