NPIMap

Organization Active NPI

Ko Olauloa Health Center

Doing business as Ko'olauloa Community Health and Wellness Center, Kahuku Medical

  • Federally Qualified Health Center (FQHC)
  • Kahuku, HI
National Provider Identifier
1528026952
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
KO OLAULOA HEALTH CENTER
Doing business as
Ko'olauloa Community Health and Wellness Center, Kahuku Medical
Practice address
56-119 Pualalea St.
Kahuku, HI 96731
Phone
(808) 293-9231
Fax
(808) 293-5390
NPI assigned
May 3, 2006
Last updated
Jul 5, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2022

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

Authorized official

Name
Terrence H Aratani
Title
Ceo
Phone
(808) 792-3840

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X HI Primary

Addresses

Primary practice location

56-119 Pualalea St.
Kahuku, HI 96731

Mailing address

PO Box 395
Kahuku, HI 96731
Phone (808) 293-9231

Other names 1

  • Ko'olauloa Community Health and Wellness Center, Kahuku Medical Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20050112001130 HI Part B Supplier - Clinic/Group Practice 0941259394 Receives reassigned benefits from 12 practitioners
2 other NPIs on this enrollment
Practice locations: Kahuku, HI; Hauula, HI
O20110218000884 HI Part A Provider - Federally Qualified Health Center (FQHC) 0941259394 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hauula, HI
O20110223001145 HI Part A Provider - Federally Qualified Health Center (FQHC) 0941259394 Practice locations: Kahuku, HI

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1528026952. Details of each certification follow.

Federally qualified health center certification: CCN 121842

Legal name
KO OLAULOA HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 23, 2011
Last certification
Feb 23, 2011
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Oct 10, 2003 in HI
Enrollment address
54-316 Kamehameha Hwy
Ste 6&7
Hauula, HI 96717-9539

Federally qualified health center certification: CCN 121843

Legal name
KO OLAULOA HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 23, 2011
Last certification
Feb 23, 2011
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Oct 10, 2003 in HI
Enrollment address
56-119 Pualalea St
Kahuku, HI 96731-2052

Other NPIs with the same Medicare PAC ID 1

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

  • Ko Olauloa Health Center

    dba Ko'olauloa Community Health and Wellness Center, Hauula Medical

    • Federally Qualified Health Center (FQHC)
    • Hauula, HI
    • NPI 1063833655

    0941259394

    Same PAC ID

Other NPIs on the same Medicare enrollment 2

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

  • Ko Olauloa Health Center

    dba Ko'olauloa Community Health and Wellness Center, RRHC Medical

    • Federally Qualified Health Center (FQHC)
    • Kahuku, HI
    • NPI 1063766079

    O20050112001130

    Same enrollment
  • Ko Olauloa Health Center

    dba Ko'olauloa Community Health and Wellness Center, Hauula Medical

    • Federally Qualified Health Center (FQHC)
    • Hauula, HI
    • NPI 1063833655

    O20050112001130, O20110218000884

    Same enrollment

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Anela Olevao Individual Corporate DirectorBoard Secretary Oct 1, 2021
Donna Ching Individual Corporate DirectorBoard Treasurer Oct 1, 2021
Paula Ogimi Individual Corporate DirectorBoard Member Oct 1, 2021
Judy Fomin Individual Corporate DirectorBoard Member Jan 1, 2011
Corporate Director Jan 1, 2015
Terrence Aratani Individual Corporate OfficerCeo Jan 1, 2011
Operational/Managerial ControlCeo Jan 1, 2011 100%
Corporate OfficerCeo Apr 1, 2015
W-2 Managing EmployeeCeo Apr 1, 2015
Operational/Managerial ControlCeo Apr 1, 2015
Melissa Primacio Individual Corporate DirectorBoard Member Jan 1, 2014
Corporate DirectorBoard Vice President Jan 1, 2014
Joe Wilson Individual Corporate DirectorBoard President Oct 1, 2021
Angelique Solomon Individual Corporate Director Oct 1, 2010
Corporate Director Jan 1, 2011
Isabella Gary Individual Corporate OfficerChief Operations Officer Oct 1, 2021
Zachery Johnson Individual Corporate OfficerChief Financial Officer Aug 16, 2021
Sonny-Jean Preston Individual Corporate DirectorBoard Member Dec 1, 2021
Danielle T W Lum Individual Corporate OfficerChief Medical Officer Feb 3, 2020
Isabella Walker Individual Corporate DirectorBoard Member Apr 1, 2021

Subparts reporting this organization as parent 5

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 33

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 33

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656979200000",
    "number": "1528026952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 395",
            "city": "KAHUKU",
            "state": "HI",
            "postal_code": "96731",
            "telephone_number": "808-293-9231",
            "fax_number": "808-293-5390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56-119 PUALALEA ST.",
            "city": "KAHUKU",
            "state": "HI",
            "postal_code": "96731",
            "telephone_number": "808-293-9231",
            "fax_number": "808-293-5390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KO OLAULOA HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-03",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A",
        "authorized_official_last_name": "ARATANI",
        "authorized_official_first_name": "TERRENCE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "808-792-3840"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "HI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ko'olauloa Community Health and Wellness Center, Kahuku Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kahuku, HI

Sources for this page

Verify at the official NPI Registry.