NPIMap

Organization Active NPI

The Queens Medical Center

Doing business as Queen's Island Urgent Care

  • Urgent Care Clinic/Center
  • Ewa Beach, HI
National Provider Identifier
1417580275
Registry record updated Feb 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
THE QUEENS MEDICAL CENTER
Doing business as
Queen's Island Urgent Care
Practice address
91-6390 Kapolei Pkwy
Ewa Beach, HI 96706
Phone
(808) 735-0007
Fax
(808) 735-0021
NPI assigned
Feb 19, 2020
Last updated
Feb 19, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2020

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

Authorized official

Name
Jason Chang
Title
Coo/ Exec VP
Phone
(808) 691-7989

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X NU Primary

Addresses

Primary practice location

91-6390 Kapolei Pkwy
Ewa Beach, HI 96706

Mailing address

449 Kapahulu Ave Ste 104
Honolulu, HI 96815-3850
Phone (808) 735-0007

Other names 1

  • QUEEN'S ISLAND URGENT CARE Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040116000366 HI Part B Supplier - Clinic/Group Practice 3476454067 Receives reassigned benefits from 844 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Honolulu, HI; Kahului, HI; Kamuela, HI; Kapolei, HI; Lihue, HI; Mililani, HI; Wahiawa, HI; Aiea, HI…

Other NPIs on the same Medicare enrollment 10

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

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
12D2181365Queen's Island Urgent Care91-6390 Kapolei Parkway, Ewa Beach, HI 96706Certificate of waiverMar 31, 2028

National Provider Directory

National Provider Directory
Tax ID family
Queens Pob Pharmacy20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

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

View all 19

Practitioners & affiliated clinicians

Practitioners 53

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 53

NPI Registry JSON

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

{
    "created_epoch": "1582070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582070400000",
    "number": "1417580275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "449 KAPAHULU AVE STE 104",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968153850",
            "telephone_number": "808-735-0007",
            "fax_number": "808-735-0021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91-6390 KAPOLEI PKWY",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "96706",
            "telephone_number": "808-735-0007",
            "fax_number": "808-735-0021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE QUEENS MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-19",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "COO/ EXEC VP",
        "authorized_official_telephone_number": "808-691-7989"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "QUEEN'S ISLAND URGENT CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ewa Beach, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2020; 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.