NPIMap

Organization Active NPI

Kokua Healthcare LLC

  • Home Health Agency
  • Lihue, HI
National Provider Identifier
1376390096
Registry record updated Apr 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
KOKUA HEALTHCARE LLC
Practice address
3-3204 Kuhio Hwy Ste 103
Lihue, HI 96766-1135
Phone
(808) 466-1863
Fax
(808) 900-3647
NPI assigned
May 1, 2024
Last updated
Apr 25, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2025

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

Authorized official

Name
Mr. Jacob Russell Mauer
Title
Ceo
Phone
(808) 466-1863

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

3-3204 Kuhio Hwy Ste 103
Lihue, HI 96766-1135

Mailing address

326 PO Box
Kalaheo, HI 96741
Phone (808) 466-1863

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250529003144 HI Part A Provider - Home Health Agency 0547779845 Practice locations: Lihue, HI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1376390096. Details of each certification follow.

Home health agency certification: CCN 127319

Legal name
KOKUA HEALTHCARE LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jul 30, 2025
Last certification
Jul 30, 2025
Organization structure
LLCProprietary
Incorporated
May 4, 2022 in HI
Enrollment address
3-3204 Kuhio Hwy
Ste 103
Lihue, HI 96766-1135
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Kokua Healthcare LLCCCN 127319 · All quality measures
Ownership
-
Certified
Jul 30, 2025
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Kokua Healthcare9 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.

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Jacob Mauer Individual 5% Or Greater Direct Ownership InterestCeo May 4, 2022 50%
Operational/Managerial ControlCeo May 4, 2022 50%
Iris Erickson Individual 5% Or Greater Direct Ownership InterestCoo May 4, 2022 50%
Operational/Managerial ControlCoo May 4, 2022 50%

NPI Registry JSON

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

{
    "created_epoch": "1714521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745539200000",
    "number": "1376390096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 PO BOX",
            "city": "KALAHEO",
            "state": "HI",
            "postal_code": "96741",
            "telephone_number": "808-466-1863",
            "fax_number": "808-900-3647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3-3204 KUHIO HWY STE 103",
            "city": "LIHUE",
            "state": "HI",
            "postal_code": "967661135",
            "telephone_number": "808-466-1863",
            "fax_number": "808-900-3647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOKUA HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-01",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "status": "A",
        "authorized_official_last_name": "MAUER",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "808-466-1863",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lihue, HI

Sources for this page

Verify at the official NPI Registry.