NPIMap

Organization Active NPI

Maui Health System a Kaiser Foundation Hospitals LLC

Doing business as Maui Memorial Medical Center Outpatient Clinic

  • Specialist
  • Wailuku, HI
National Provider Identifier
1699206276
Registry record updated Sep 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
MAUI HEALTH SYSTEM A KAISER FOUNDATION HOSPITALS LLC
Doing business as
Maui Memorial Medical Center Outpatient Clinic
Practice address
85 Maui Lani Parkway
Wailuku, HI 96793-2581
Phone
(808) 442-5700
NPI assigned
Mar 24, 2017
Last updated
Sep 3, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2021

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

Authorized official

Name
Joyce Tamori
Title
VP, Cfo
Phone
(808) 243-3095

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

85 Maui Lani Parkway
Wailuku, HI 96793-2581

Mailing address

221 Mahalani St
Wailuku, HI 96793-2526

Other names 1

  • Maui Memorial Medical Center Outpatient Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170725002612 HI Part B Supplier - Clinic/Group Practice 9830476159 Receives reassigned benefits from 139 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kula, HI; Wailuku, HI; Lanai City, HI

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory
Tax ID family
Maui Health System a Kaiser Foundation Hospitals LLC9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1490313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630627200000",
    "number": "1699206276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 MAHALANI ST",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967932526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 MAUI LANI PARKWAY",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967932581",
            "telephone_number": "808-442-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAUI HEALTH SYSTEM A KAISER FOUNDATION HOSPITALS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-24",
        "last_updated": "2021-09-03",
        "certification_date": "2021-09-03",
        "status": "A",
        "authorized_official_last_name": "TAMORI",
        "authorized_official_first_name": "JOYCE",
        "authorized_official_title_or_position": "VP, CFO",
        "authorized_official_telephone_number": "808-243-3095"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maui Memorial Medical Center Outpatient Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Maui Memorial Medical Center Outpatient Clinic",
            "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 Sep 3, 2021; 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.