NPIMap

Organization Active NPI

Kau Hospital

Doing business as East Hawaii Health Clinic at Puna Kai

  • Rural Health Clinic/Center
  • Pahoa, HI
National Provider Identifier
1285450163
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
KAU HOSPITAL
Doing business as
East Hawaii Health Clinic at Puna Kai
Practice address
15-2714 Pahoa Village Rd Ste 5
Pahoa, HI 96778-9715
Phone
(808) 930-6001
Fax
(808) 930-6007
NPI assigned
Nov 25, 2024
Last updated
Feb 25, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Authorized official

Name
Joni Mu Waltjen
Title
Regional Cfo
Phone
(808) 932-3110

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

15-2714 Pahoa Village Rd Ste 5
Pahoa, HI 96778-9715

Mailing address

PO Box 40
Pahala, HI 96777-0040
Phone (808) 932-4300

Other names 1

  • East Hawaii Health Clinic at Puna Kai Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250320000260 HI Part A Provider - Rural Health Clinic 7416945548 Practice locations: Pahoa, HI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1285450163. Details of each certification follow.

Rural health clinic certification: CCN 123400

Legal name
KAU HOSPITAL
Doing business as
EAST HAWAII HEALTH CLINIC AT PUNA K
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jun 30, 2025
Last certification
Jun 30, 2025
Ownership / control type
2B
Organization structure
OtherNon-profit
Enrollment address
15-2714 Pahoa Village Road
Building L, Suite 5
Pahoa, HI 96778
Related CCNs
121301

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 8

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

  • Kau Hospital
    • Rural Health Clinic/Center
    • Pahala, HI
    • NPI 1144304338

    7416945548

    Same PAC ID
  • Kau Hospital

    dba East Hawaii Health Primary Care

    • Rural Health Clinic/Center
    • Hilo, HI
    • NPI 1154111607

    7416945548

    Same PAC ID
  • Kau Hospital

    dba East Hawaii Health Clinic at 1285 Waianuenue

    • Rural Health Clinic/Center
    • Hilo, HI
    • NPI 1164083374

    7416945548

    Same PAC ID
  • Kau Hospital

    dba East Hawaii Health Clinic at Pahoa

    • Rural Health Clinic/Center
    • Pahoa, HI
    • NPI 1174777916

    7416945548

    Same PAC ID
  • Kau Hospital

    dba East Hawaii Health Clinic at 1190 Waianuenue

    • Rural Health Clinic/Center
    • Hilo, HI
    • NPI 1336789874

    7416945548

    Same PAC ID
  • Kau Hospital
    • Critical Access Hospital
    • Pahala, HI
    • NPI 1558441311

    7416945548

    Same PAC ID
  • Kau Hospital

    dba East Hawaii Health Clinic at Kea'au

    • Rural Health Clinic/Center
    • Kea'au, HI
    • NPI 1649876913

    7416945548

    Same PAC ID
  • Kau Hospital
    • Medicare Defined Swing Bed Hospital Unit
    • Pahala, HI
    • NPI 1902977440

    7416945548

    Same PAC ID

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
12D2317832East Hawaii Health Clinic at Puna Kai15-2714 Pahoa Village Road, Building L Suite #5, Pahoa, HI 96778Certificate of waiverJan 30, 2027

National Provider Directory

National Provider Directory
Tax ID family
Kau Hospital8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

1285 Waianuenue Ave
Hilo, HI 96720
Phone (808) 932-3878

75 Puuhonu Pl
Ste 100
Hilo, HI 96720
Phone (808) 932-3940

16-523 Keaau Pahoa Rd
Keaau, HI 96749
Phone (808) 932-3801

15-2714 Pahoa Village Rd
Bldg L
Pahoa, HI 96778

15-2714 Pahoa Village Rd
Ste 5
Pahoa, HI 96778
Phone (808) 930-6001

Ownership & related parties

All disclosed owners & managing parties 17

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Stephen M Smith Individual Corporate DirectorRegional Board Member Feb 24, 2018
Daniel H Belcher Individual Corporate DirectorRegional Board Member Jul 1, 2023
Randall Kurohara Individual Corporate DirectorRegional Board Member Jul 1, 2022
Lara Gomez Individual Corporate DirectorRegional Board Member Jul 1, 2022
Jay M Ignacio Individual Corporate DirectorRegional Board Member Apr 1, 2019
Yvonne Wong Individual Corporate DirectorRegional Board Member Jul 1, 2022
Daniel John Brinkman Individual Corporate OfficerRegional Ceo Jun 22, 2015
Jennifer J Walker Individual Contracted Managing EmployeeMD; Aug 29, 2019
Chad Keone Farias Individual Corporate DirectorRegional Board Member Jul 1, 2021
Joseph F Skruch Individual Corporate DirectorRegional Board Member Jul 1, 2019
Deanna S Sako Individual Corporate DirectorRegional Board Member Sep 1, 2018
Jennifer L Zelko-Schlueter Individual Corporate DirectorRegional Chairman of the Board Aug 19, 2014
Joni Mu Waltjen Individual Corporate OfficerRegional Cfo Apr 8, 2002
Juliette M Tulang Individual Corporate DirectorRegional Board Member Jul 1, 2023
Hawaii Health Systems Corporation Organization, Honolulu, HI Non-profit 5% Or Greater Direct Ownership Interest Jul 1, 1996 100%
Clarysse K Nunokawa Individual Corporate DirectorRegional Board Member Jun 1, 2019
Lauri E Redus Individual W-2 Managing EmployeeAd; Oct 31, 2016

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 34

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 34

Practitioners & affiliated clinicians

Practitioners 212

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.

View all 212

NPI Registry JSON

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

{
    "created_epoch": "1732492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740441600000",
    "number": "1285450163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40",
            "city": "PAHALA",
            "state": "HI",
            "postal_code": "967770040",
            "telephone_number": "808-932-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15-2714 PAHOA VILLAGE RD STE 5",
            "city": "PAHOA",
            "state": "HI",
            "postal_code": "967789715",
            "telephone_number": "808-930-6001",
            "fax_number": "808-930-6007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAU HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-25",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-04",
        "status": "A",
        "authorized_official_last_name": "WALTJEN",
        "authorized_official_first_name": "JONI",
        "authorized_official_middle_name": "MU",
        "authorized_official_title_or_position": "REGIONAL CFO",
        "authorized_official_telephone_number": "808-932-3110"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Hawaii Health Clinic at Puna Kai",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pahoa, HI

Sources for this page

Verify at the official NPI Registry.