NPIMap

Organization Active NPI

Kihei-Wailea Medical Center. LLC

  • Specialist
  • Kihei, HI
National Provider Identifier
1255475752
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
KIHEI-WAILEA MEDICAL CENTER. LLC
Practice address
221 Piikea Ave # a
Kihei, HI 96753-8268
Phone
(808) 874-8100
Fax
(808) 874-6887
NPI assigned
Feb 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Gini Santos
Title
Office Manager
Phone
(808) 270-0491

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

221 Piikea Ave # a
Kihei, HI 96753-8268

Mailing address

221 Piikea Ave # a
Kihei, HI 96753-8268
Phone (808) 874-8100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040323000401 HI Part B Supplier - Clinic/Group Practice 9739070459 Receives reassigned benefits from 12 practitioners
Practice locations: Kihei, HI

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
12D0619545Kihei Wailea Medical Center221 Piikea Avenue Suite a, Kihei, HI 96753Provider-performed microscopyAug 31, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255475752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 PIIKEA AVE # A",
            "city": "KIHEI",
            "state": "HI",
            "postal_code": "967538268",
            "telephone_number": "808-874-8100",
            "fax_number": "808-874-6887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 PIIKEA AVE # A",
            "city": "KIHEI",
            "state": "HI",
            "postal_code": "967538268",
            "telephone_number": "808-874-8100",
            "fax_number": "808-874-6887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIHEI-WAILEA MEDICAL CENTER. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SANTOS",
        "authorized_official_first_name": "GINI",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "808-270-0491"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kihei, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.