Organization Active NPI

Hale Maka Ike LLC

  • Optometrist
  • Honolulu, HI
National Provider Identifier
1487928750
Registry record updated Mar 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
HALE MAKA IKE LLC
Practice address
1620 Ala Moana Blvd
Suite 500
Honolulu, HI 96815-1437
Phone
(808) 955-0255
Fax
(808) 955-4155
NPI assigned
Mar 2, 2012
Last updated
Mar 20, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2020

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

Authorized official

Name
Michael D. Bennett, MDNPI 1043274111
Title
President
Phone
(808) 955-0255

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
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X Primary
Low Vision Rehabilitation OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152WL0500X

Addresses

Primary practice location

1620 Ala Moana Blvd
Suite 500
Honolulu, HI 96815-1437

Mailing address

PO Box 1300
Mailcode 61289
Honolulu, HI 96807-1300
Phone (808) 955-0255

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120613000454 HI Part B Supplier - Clinic/Group Practice 4082878574 Receives reassigned benefits from 1 practitioner
Practice locations: Honolulu, HI; Kahului, HI; Kailua Kona, HI; Lihue, HI; Waipahu, HI; Hilo, HI

National Provider Directory

National Provider Directory

Locations

1620 Ala Moana Blvd
Ste 50
Honolulu, HI 96815

77-6403 Nalani St
Fl 2
Kailua Kona, HI 96740

4418 Kukui Grove St
Lihue, HI 96766
Phone (808) 245-5377

94-216 Farrington Hwy
#B2203
Waipahu, HI 96797

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1330646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584662400000",
    "number": "1487928750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1300",
            "address_2": "MAILCODE 61289",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968071300",
            "telephone_number": "808-955-0255",
            "fax_number": "808-955-4155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 ALA MOANA BLVD",
            "address_2": "SUITE 500",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968151437",
            "telephone_number": "808-955-0255",
            "fax_number": "808-955-4155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HALE MAKA IKE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-02",
        "last_updated": "2020-03-20",
        "certification_date": "2020-03-20",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "808-955-0255",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.