Organization Active NPI

Kona Kohala Health Care Services Inc

  • Internal Medicine Physician
  • Kailua Kona, HI
National Provider Identifier
1407928492
Registry record updated Sep 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
KONA KOHALA HEALTH CARE SERVICES INC
Practice address
75-137 Hualalai Rd
Kailua Kona, HI 96740-1703
Phone
(808) 329-1346
Fax
(808) 329-1575
NPI assigned
Nov 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2014

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

Authorized official

Name
Dr. Richard A. Pekala, M.D.NPI 1336174341
Title
President
Phone
(808) 329-1346

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X

Addresses

Primary practice location

75-137 Hualalai Rd
Kailua Kona, HI 96740-1703

Mailing address

75-137 Hualalai Rd
Kailua Kona, HI 96740-1703
Phone (808) 329-1346

Other identifiers 1

IdentifierTypeStateIssuer
00A0026490OtherHIHAWAII MEDICAL SVC ASSOC

Other names 1

  • KONA KOHALA MEDI CAL ASSOCIATES Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040611001451 HI Part B Supplier - Clinic/Group Practice 7214910991 Receives reassigned benefits from 2 practitioners
Practice locations: Kailua Kona, HI

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
12D1066453Kona Kohala Health Care SVCS75-137 Hualalai Rd, Kailua Kona, HI 96740Certificate of waiverMar 22, 2027

National Provider Directory

National Provider Directory

Locations

75-137 Hualalai Rd
Kailua Kona, HI 96740
Phone (808) 329-1340

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409788800000",
    "number": "1407928492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75-137 HUALALAI RD",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967401703",
            "telephone_number": "808-329-1346",
            "fax_number": "808-329-1575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75-137 HUALALAI RD",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967401703",
            "telephone_number": "808-329-1346",
            "fax_number": "808-329-1575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KONA KOHALA HEALTH CARE SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2014-09-04",
        "status": "A",
        "authorized_official_last_name": "PEKALA",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "808-329-1346",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAWAII MEDICAL SVC ASSOC",
            "identifier": "00A0026490",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KONA KOHALA MEDI CAL ASSOCIATES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kailua Kona, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2014; 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.