NPIMap

Organization Active NPI

Maui Health System a Kaiser Foundation Hospitals LLC

Doing business as Lanai Community Hospital

  • Critical Access Hospital
  • Lanai City, HI
National Provider Identifier
1336501634
Registry record updated Sep 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
MAUI HEALTH SYSTEM A KAISER FOUNDATION HOSPITALS LLC
Doing business as
Lanai Community Hospital
Practice address
628 Seventh Street
Lana'I City, HI 96763
Phone
(808) 545-6411
NPI assigned
Mar 25, 2016
Last updated
Sep 3, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2021

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

Authorized official

Name
Joyce Tamori
Title
VP, Cfo
Phone
(808) 243-3095

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X Primary

Addresses

Primary practice location

628 Seventh Street
Lana'I City, HI 96763

Mailing address

221 Mahalani St
Wailuku, HI 96793-2526

Other identifiers 1

IdentifierTypeStateIssuer
25187701MedicaidHI

Other names 1

  • Lanai Community Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20170411000803 HI Part A Provider - Critical Access Hospital 9830476159 Practice locations: Lanai City, HI
O20170725002612 HI Part B Supplier - Clinic/Group Practice 9830476159 Receives reassigned benefits from 139 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kula, HI; Wailuku, HI; Lanai City, HI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1336501634. Details of each certification follow.

Hospital certification: CCN 121305

Legal name
MAUI HEALTH SYSTEM A KAISER FOUNDATION HOSPITALS LLC
Doing business as
LANAI COMMUNITY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Dec 9, 2001
Last certification
Oct 27, 2023
Beds
4
Ownership / control type
Private (not for profit)
Most recent change of ownership
Jul 1, 2017 (1 total)
Organization structure
LLCNon-profit
Incorporated
Dec 24, 2015 in HI
Enrollment address
628 7TH St
Lanai City, HI 96763
Other Hospital Practice Location

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Lanai Community HospitalCCN 121305 · All quality measures
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Maui Health System a Kaiser9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Richard Clay Sutherland Individual Corporate DirectorDirector, Maui Health System, a Jul 1, 2017 100%
Anthony Paul Takitani Individual Corporate DirectorDirector, Maui Health System Jul 1, 2017 100%
John M Yamamoto Individual Corporate DirectorDirector, Maui Health System, a Jul 1, 2017 100%
Michael a Rembis Individual Corporate OfficerCeo & Hospital Administrator - MHS Sep 1, 2017
W-2 Managing EmployeeCeo & Hospital Administrator - MHS Sep 1, 2017
Operational/Managerial ControlCeo & Hospital Administrator - MHS Sep 1, 2017
Kathryn Lancaster Individual Corporate DirectorDirector, Maui Health System a Kais Jul 1, 2017
Mary M Hew Individual Corporate DirectorDirector, Maui Health System, a Jul 1, 2017 100%
Tamar Goodfellow Individual Corporate DirectorDirector Mar 31, 2021 100%
Kaiser Foundation Hospitals Organization, Oakland, CA Corporation, Non-profit 5% Or Greater Direct Ownership Interest Dec 24, 2015 100%
Wade Ebersole Individual Corporate OfficerVP, Coo - MHS Feb 23, 2023 100%
W-2 Managing EmployeeVP, Coo - MHS Feb 23, 2023 100%
Operational/Managerial ControlVP, Coo - MHS Feb 23, 2023
Stephen D Miller Individual Corporate DirectorDirector, Maui Health System, a Jul 1, 2017 100%
Bryan C Smith Individual Corporate DirectorDirector, Maui Health System, a Jul 1, 2017 100%
Maui Health System a Kaiser Foundation Hospitals LLC Organization, Wailuku, HI LLC, Non-profit Operational/Managerial Control Jul 1, 2017 100%

Owners & managing parties with NPI records 5

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

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Kula HospitalKula, HI, CCN 121308 Hospital Operational/Managerial Control (100%) Jul 1, 2017
Kula HospitalKula, HI, CCN 12Z308 Hospital Operational/Managerial Control (100%) Jul 1, 2017

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 78

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

View all 78

Practitioners & affiliated clinicians

Practitioners 21

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 21

Affiliated clinicians 11

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": "1458864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630627200000",
    "number": "1336501634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 MAHALANI ST",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967932526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 SEVENTH STREET",
            "city": "LANA'I CITY",
            "state": "HI",
            "postal_code": "96763",
            "telephone_number": "808-545-6411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAUI HEALTH SYSTEM A KAISER FOUNDATION HOSPITALS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-25",
        "last_updated": "2021-09-03",
        "certification_date": "2021-09-03",
        "status": "A",
        "authorized_official_last_name": "TAMORI",
        "authorized_official_first_name": "JOYCE",
        "authorized_official_title_or_position": "VP, CFO",
        "authorized_official_telephone_number": "808-243-3095"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "25187701",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lanai Community Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lanai Community Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lanai City, HI

Sources for this page

Verify at the official NPI Registry.