NPIMap

Organization Active NPI

Rehabilitation Hospital of the Pacific

Doing business as REHAB at Hilo

  • Rehabilitation Clinic/Center
  • Hilo, HI
National Provider Identifier
1174632897
Registry record updated Jun 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
License
OHCA#35H Issued in HI
Legal business name
REHABILITATION HOSPITAL OF THE PACIFIC
Doing business as
REHAB at Hilo
Practice address
76 Puuhonu PL
Hilo, HI 96720-2001
Phone
(808) 961-5776
Fax
(808) 961-6473
NPI assigned
Aug 29, 2006
Last updated
Jun 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2022

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

Authorized official

Name
Stephanie Nadolny
Title
President & Ceo
Phone
(808) 566-3815

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X OHCA#35H HI Primary

Addresses

Primary practice location

76 Puuhonu PL
Hilo, HI 96720-2001

Mailing address

226 N Kuakini St
Honolulu, HI 96817-2421
Phone (808) 531-3511

Other identifiers 4

IdentifierTypeStateIssuer
96720B001OtherCHAMPUS
144692906OtherOWCP
00D0208555OtherALL HMSA PLANS
51994401MedicaidHI

Other names 1

  • REHAB at Hilo Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031021000020 HI Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 9436068442 Practice locations: Hilo, HI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1174632897. Details of each certification follow.

  • CCN 126517 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 126517

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
REHAB AT HILO
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Jun 10, 2004
Last certification
Aug 2, 2019
Ownership / control type
Voluntary Non-Profit Other Than Church
Facility address
76 Puuhonu Place
Hilo, HI 96720

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
Rehabilitation Hospital of the Pacific6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

76 Puuhonu Pl
Hilo, HI 96720
Phone (808) 961-5776

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Rehabilitation Hospital of the PacificHonolulu, HI, CCN 123025 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Aug 13, 1975
Aug 13, 1975

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 1

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": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655683200000",
    "number": "1174632897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 N KUAKINI ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968172421",
            "telephone_number": "808-531-3511",
            "fax_number": "808-544-3377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 PUUHONU PL",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967202001",
            "telephone_number": "808-961-5776",
            "fax_number": "808-961-6473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHABILITATION HOSPITAL OF THE PACIFIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A",
        "authorized_official_last_name": "NADOLNY",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "808-566-3815"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "HI",
            "license": "OHCA#35H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "96720B001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCP",
            "identifier": "144692906",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALL HMSA PLANS",
            "identifier": "00D0208555",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "51994401",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "REHAB at Hilo",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "REHAB at Hilo",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hilo, HI

Sources for this page

Verify at the official NPI Registry.