NPIMap

Organization Active NPI

Liberty Dialysis - Hawaii LLC

Doing business as Liberty Dialysis Hawaii - Kahana Dialysis Facility

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Lahaina, HI
National Provider Identifier
1275574170
Registry record updated Aug 29, 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
Doing business as
Liberty Dialysis Hawaii - Kahana Dialysis Facility
Practice address
4405 Honoapiilani Hwy Ste 208
Lahaina, HI 96761-9272
Phone
(808) 669-6628
Fax
(808) 669-1272
NPI assigned
Jun 10, 2006
Last updated
Aug 29, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
FRESENIUS MEDICAL CARE HOLDINGS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 29, 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 NU Primary

Addresses

Primary practice location

4405 Honoapiilani Hwy Ste 208
Lahaina, HI 96761-9272

Mailing address

4405 Honoapiilani Hwy Ste 208
Lahaina, HI 96761-9272
Phone (808) 669-6628

Other identifiers 1

IdentifierTypeStateIssuer
00L0257463MedicaidHI

Other names 1

  • LIBERTY DIALYSIS HAWAII - KAHANA DIALYSIS FACILITY 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
O20051213000911 HI Part A Provider - End-Stage Renal Disease Facility (ESRD) 1456372879 Practice locations: Lahaina, 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

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
12D2170677Liberty Dialysis - Hawaii LLC - Kahana Dialysis4405 Honoapiilani Hwy, Suite 208, Lahaina, HI 96761Certificate of waiverAug 14, 2027

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.

Locations

4405 Honoapiilani Hwy
Ste 208
Lahaina, HI 96761
Phone (808) 669-6628

NPI Registry JSON

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787961600000",
    "number": "1275574170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4405 HONOAPIILANI HWY STE 208",
            "city": "LAHAINA",
            "state": "HI",
            "postal_code": "967619272",
            "telephone_number": "808-669-6628",
            "fax_number": "808-669-1272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 HONOAPIILANI HWY STE 208",
            "city": "LAHAINA",
            "state": "HI",
            "postal_code": "967619272",
            "telephone_number": "808-669-6628",
            "fax_number": "808-669-1272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY DIALYSIS - HAWAII LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRESENIUS MEDICAL CARE HOLDINGS, INC.",
        "enumeration_date": "2006-06-10",
        "last_updated": "2026-08-29",
        "certification_date": "2026-08-29",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00L0257463",
            "state": "HI"
        }
    ],
    "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 - KAHANA DIALYSIS FACILITY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lahaina, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.