NPIMap

Organization Active NPI

Shalom Hospice of Hawaii LLC

  • Community Based Hospice Care Agency
  • Honolulu, HI
National Provider Identifier
1306640412
Registry record updated Jun 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
SHALOM HOSPICE OF HAWAII LLC
Practice address
677 Ala Moana Blvd Ste 725
Honolulu, HI 96813-5417
Phone
(808) 556-5900
Fax
(808) 490-0960
NPI assigned
Apr 1, 2025
Last updated
Jun 9, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2026

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

Authorized official

Name
Samuel Stern
Title
Ceo
Phone
(510) 499-9977

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

677 Ala Moana Blvd Ste 725
Honolulu, HI 96813-5417

Mailing address

677 Ala Moana Blvd Ste 725
Honolulu, HI 96813-5417
Phone (808) 556-5900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250625001049 HI Part A Provider - Hospice 0648782607 Practice locations: Honolulu, HI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1306640412. Details of each certification follow.

Hospice certification: CCN 121513

Legal name
SHALOM HOSPICE OF HAWAII LLC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Oct 22, 2025
Last certification
Oct 22, 2025
Ownership / control type
Proprietary - Corporation
Organization structure
LLCProprietary
Enrollment address
677 Ala Moana Blvd
Ste 725
Honolulu, HI 96813-5417

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Starco Management LLC Organization, Brooklyn, NY LLC, Holding company 5% Or Greater Direct Ownership Interest Jul 25, 2022 100%
Samuel Stern Individual Contracted Managing EmployeeCeo Jul 25, 2022
5% Or Greater Indirect Ownership Interest Jul 25, 2022 10%
Corporate OfficerCeo Jul 25, 2022
Corporate DirectorCeo Jul 25, 2022
Operational/Managerial ControlCeo Jul 25, 2022
James Loughran Individual W-2 Managing EmployeeMD; Jun 20, 2025
Stern Family 2019 Trust Organization, Brooklyn, NY LLC 5% Or Greater Indirect Ownership Interest Jul 25, 2022 90%
Michelle R Allen Individual W-2 Managing EmployeeAd; Jun 1, 2025
Mia Gomes Individual W-2 Managing EmployeeClinical Director Mar 11, 2026

Owners & managing parties with NPI records 1

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

Facilities with the same owner 12

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

Practitioners & affiliated clinicians

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1743465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780963200000",
    "number": "1306640412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "677 ALA MOANA BLVD STE 725",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968135417",
            "telephone_number": "808-556-5900",
            "fax_number": "808-490-0960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "677 ALA MOANA BLVD STE 725",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968135417",
            "telephone_number": "808-556-5900",
            "fax_number": "808-490-0960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHALOM HOSPICE OF HAWAII LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-01",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A",
        "authorized_official_last_name": "STERN",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "510-499-9977"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.