NPIMap

Organization Active NPI

Liberty Dialysis - Hawaii LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Waianae, HI
National Provider Identifier
1124620869
Registry record updated Aug 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
LIBERTY DIALYSIS - HAWAII LLC
Practice address
89-102 Farrington Hwy
Waianae, HI 96792-4158
Phone
(808) 380-0626
Fax
(808) 628-4078
NPI assigned
Nov 9, 2020
Organization subpart
Yes
Parent organization
FRESENIUS MEDICAL CARE HOLDINGS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 27, 2026

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

Authorized official

Name
Denise Wright
Title
Vice President
Phone
(781) 676-5200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Primary

Addresses

Primary practice location

89-102 Farrington Hwy
Waianae, HI 96792-4158

Mailing address

89-102 Farrington Hwy
Waianae, HI 96792-4158
Phone (808) 380-0626

Other names 1

  • LIBERTY DIALYSIS HAWAII, LLC-WAIANAE COAST NANAKULI Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Bluemark LLC / Office Ally

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201222000204 HI Part A Provider - End-Stage Renal Disease Facility (ESRD) 1456372879 Practice locations: Waianae, HI

Other NPIs with the same Medicare PAC ID 18

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

View all 18

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
Liberty Waianae Coast NanakuliCCN 122538
Overall star rating
3.0 of 5
Ownership
Profit
Certified
Apr 26, 2021
Medicare certification status
ActiveFrom the Provider of Services file
Chain
Fresenius Medical Care
Dialysis stations
36

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
12D2191734Liberty Dialysis Hawaii - Waianae Coast Nanakuli89-102 Farrington Hwy, Waianae, HI 96792Certificate of waiverAug 30, 2026

National Provider Directory

National Provider Directory
Tax ID family
Ability Network22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

Organizations that report the same tax identification number in the National Provider Directory.

View all 21

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1604880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787788800000",
    "number": "1124620869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89-102 FARRINGTON HWY",
            "city": "WAIANAE",
            "state": "HI",
            "postal_code": "967924158",
            "telephone_number": "808-380-0626",
            "fax_number": "808-628-4078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89-102 FARRINGTON HWY",
            "city": "WAIANAE",
            "state": "HI",
            "postal_code": "967924158",
            "telephone_number": "808-380-0626",
            "fax_number": "808-628-4078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY DIALYSIS - HAWAII LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRESENIUS MEDICAL CARE HOLDINGS, INC.",
        "enumeration_date": "2020-11-09",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "781-676-5200"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC / Office Ally",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1300 SE Cardinal Ct Ste 190",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986839683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "LIBERTY DIALYSIS HAWAII, LLC-WAIANAE COAST NANAKULI",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waianae, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2026; 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.