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Kauai Veterans Memorial Hospital

Organization Active NPI Medicare Defined Swing Bed Hospital Unit · Waimea, HI

NPI 1649345968 · NPPES record last updated Nov 30, 2016

Key facts

NPI
1649345968
Entity type
Organization (NPI type 2)
Primary specialty
Medicare Defined Swing Bed Hospital Unit 275N00000X
License
21H (HI)
Legal business name
KAUAI VETERANS MEMORIAL HOSPITAL
Practice address
4643 Waimea Canyon Drive
Waimea, HI 96796
Phone
(808) 338-9431
Fax
(808) 338-9235
NPI assigned
Nov 21, 2006
Organization subpart
No

Authorized official

Name
Ms. Rachelle M D Lorenzo
Title
Cfo
Phone
(808) 338-9431

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs with the same Medicare PAC ID 3

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

Facilities connected through Provider of Services related, parent or unit certification numbers.

Facilities with the same owner 34

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 34

Practitioners 19

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

Affiliated clinicians 4

Clinicians who list this facility as an affiliation in Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in HI

Hospital certification: CCN 12Z300

Legal name
KAUAI VETERANS MEMORIAL HOSPITAL
Organization structure
Other · Non-profit
Incorporated
Jul 1, 1996 in HI
Enrollment address
4643 Waimea Canyon Dr
Waimea, HI 96796
Other Hospital Practice Location

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Lance K Segawa
Individual 		Corporate Officer
Regional Chief Executive Officer		 Apr 1, 2018 100%
W-2 Managing Employee
Regional Chief Executive Officer		 Apr 1, 2018 100%
Operational/Managerial Control
Regional Chief Executive Officer		 Apr 1, 2018 100%
Rhonelle Aceret
Individual 		W-2 Managing Employee
Credentialing Coordinator		 Dec 17, 2018
Laurel K S Loo
Individual 		Corporate Director May 17, 2017 10%
Donna Okada-Asher
Individual 		Corporate Director May 17, 2017 10%
Patrick S Gegen
Individual 		Corporate Director
Board Member		 Nov 1, 2012 10%
Hawaii Health Systems Corporation
Organization · Honolulu, HI
Created for acquisition, LLC 		5% Or Greater Direct Ownership Interest Jul 1, 1996 100%
Stephanie N Iona
Individual 		Corporate Director
Board Member		 Nov 1, 2012 10%
Christine M Asato
Individual 		Corporate Officer
Regional Chief Financial Officer		 Apr 1, 2018 50%
W-2 Managing Employee
Regional Chief Financial Officer		 Apr 1, 2018 50%
Operational/Managerial Control
Regional Chief Financial Officer		 Apr 1, 2018 50%

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Kauai Veterans Memorial Hospital
Waimea, HI · CCN 125021		 Skilled nursing facility 5% Or Greater Direct Ownership Interest (80%) Jul 1, 1996

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20180514000835 HI Part a Provider - Critical Access Hospital 7911805114 Practice locations: Waimea, HI

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 21H HI Yes

Addresses

Primary practice location

4643 Waimea Canyon Drive
Waimea, HI 96796

Mailing address

PO Box 337
Waimea, HI 96796-0337
Phone (808) 338-9431

Other providers in Waimea, HI

All providers in Waimea, HI · Medicare Defined Swing Bed Hospital Unit in Hawaii

Sources for this page

Verify at the official NPI Registry.