NPIMap

Organization Active NPI

Kaiser Foundation Health Plan Inc

Doing business as Kaiser Wailuku Clinic Laboratory

  • Clinical Medical Laboratory
  • Wailuku, HI
National Provider Identifier
1669487047
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
12D0064381 Issued in HI
Legal business name
KAISER FOUNDATION HEALTH PLAN INC
Doing business as
Kaiser Wailuku Clinic Laboratory
Practice address
80 Mahalani St
Wailuku, HI 96793-2531
Phone
(808) 243-6180
Fax
(808) 243-6015
NPI assigned
Jul 31, 2006
Last updated
Feb 1, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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

Authorized official

Name
James G. Adams Jr.
Title
Executive Director, Finanace Leader
Phone
(808) 286-6758

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 12D0064381 HI Primary

Addresses

Primary practice location

80 Mahalani St
Wailuku, HI 96793-2531

Mailing address

711 Kapiolani Blvd
Billing Department
Honolulu, HI 96813-5214
Phone (808) 432-5340

Other identifiers 1

IdentifierTypeStateIssuer
549983-01MedicaidHI

Other names 1

  • Kaiser Wailuku Clinic Laboratory Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061030000109 HI Part B Supplier - Independent Clinical Laboratory 1850205360 18 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kapolei, HI; Waipahu, HI; Wailuku, HI; Waianae, HI; Lihue, HI; Lahaina, HI; Kihei, HI; Kamuela, HI…

Other NPIs on the same Medicare enrollment 18

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

View all 18

National Provider Directory

National Provider Directory
Tax ID family
Kaiser Foundation HLTH379 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 2

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": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706745600000",
    "number": "1669487047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 KAPIOLANI BLVD",
            "address_2": "BILLING DEPARTMENT",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968135214",
            "telephone_number": "808-432-5340",
            "fax_number": "808-432-5239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 MAHALANI ST",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967932531",
            "telephone_number": "808-243-6180",
            "fax_number": "808-243-6015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER FOUNDATION HEALTH PLAN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR, FINANACE LEADER",
        "authorized_official_telephone_number": "808-286-6758",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "HI",
            "license": "12D0064381",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "549983-01",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kaiser Wailuku Clinic Laboratory",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kaiser Wailuku Clinic Laboratory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wailuku, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2024; 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.