NPIMap

Organization Active NPI

Gamma Knife Center of the Pacific Inc

  • Ambulatory Surgical Clinic/Center
  • Honolulu, HI
National Provider Identifier
1184789513
Registry record updated Nov 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
0007012063 Issued in HI
Legal business name
GAMMA KNIFE CENTER OF THE PACIFIC INC
Practice address
2226 Liliha St
Level B1
Honolulu, HI 96817-1600
Phone
(808) 535-1579
Fax
(808) 535-1540
NPI assigned
Dec 26, 2006
Last updated
Nov 14, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2007

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

Authorized official

Name
Mr. Sean Leslie Nicholson
Title
Cfo
Phone
(808) 535-1579

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 0007012063 HI Primary

Addresses

Primary practice location

2226 Liliha St
Level B1
Honolulu, HI 96817-1600

Mailing address

2226 Liliha St
Level B1
Honolulu, HI 96817-1600
Phone (808) 535-1579

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040315001186 HI Part B Supplier - Clinic/Group Practice 2668361619 Receives reassigned benefits from 9 practitioners
Practice locations: Honolulu, HI

National Provider Directory

National Provider Directory

Locations

2226 Liliha St
Ste 205
Honolulu, HI 96817
Phone (808) 535-1579

2226 Liliha St
Ste B1
Honolulu, HI 96817
Phone (808) 535-1579

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": "1167091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194998400000",
    "number": "1184789513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2226 LILIHA ST",
            "address_2": "LEVEL B1",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968171600",
            "telephone_number": "808-535-1579",
            "fax_number": "808-535-1540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2226 LILIHA ST",
            "address_2": "LEVEL B1",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968171600",
            "telephone_number": "808-535-1579",
            "fax_number": "808-535-1540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAMMA KNIFE CENTER OF THE PACIFIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-26",
        "last_updated": "2007-11-14",
        "status": "A",
        "authorized_official_last_name": "NICHOLSON",
        "authorized_official_first_name": "SEAN",
        "authorized_official_middle_name": "LESLIE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "808-535-1579",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "HI",
            "license": "0007012063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 14, 2007; 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.