Malama Kidney Center, LLC

Primary specialty

Community Health Nurse PractitionerTaxonomy code 363LC1500X

Legal business name

MALAMA KIDNEY CENTER, LLC

Practice address

1357 Kapiolani Blvd Ste 1460
Honolulu, HI 96814-4509

Phone

(808) 942-1852

Fax

(808) 943-8732

NPI assigned

Jul 25, 2019

Organization subpart

Yes

Parent organization

PMAG CARE, INCAs reported in NPPES

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

Authorized official

Name

Gregg Shimomura, MDNPI 1538280367

Title

Medical Director

Phone

(808) 942-1852

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in HI

Enrollment records 1

Locations

Practitioners 3

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

• Anthone T Jeon, NP-C

  • Primary Care Nurse Practitioner
  • Honolulu, HI
  • NPI 1871149948
  Medicare reassignment Care Compare group NPD
• Ruby Ann Hayasaka, RDN

  • Registered Dietitian
  • Honolulu, HI
  • NPI 1831723071
  Medicare reassignment Care Compare group
• Gregg Atsushi Shimomura, MD

  • Obstetrics & Gynecology Physician
  • Aiea, HI
  • NPI 1538280367
  NPD Authorized official

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

{
    "created_epoch": "1564012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664236800000",
    "number": "1699329839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1357 KAPIOLANI BLVD STE 1460",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968144509",
            "telephone_number": "808-942-1852",
            "fax_number": "808-943-8732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1357 KAPIOLANI BLVD STE 1460",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968144509",
            "telephone_number": "808-942-1852",
            "fax_number": "808-943-8732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MALAMA KIDNEY CENTER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PMAG CARE, INC",
        "enumeration_date": "2019-07-25",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A",
        "authorized_official_last_name": "SHIMOMURA",
        "authorized_official_first_name": "GREGG",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "808-942-1852",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363LC1500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Malaga Larrain Sr.
• Malama Adult Day Care LLC
• Malama Counseling Services LLC
• Malama Dermatology, LLC (Malama Dermatology)
• Malama Imaging LLC
• Malama Maikai Health and Wellness Alliance LLC
• Malama Ohana Nursing and Rehab Center
• Malama Ola Health Services LLC
• Malama Ola Health Services LLC (Hui Kokua)
• Malama Recovery Hi LLC

• Community Health Nurse Practitioner in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Community Health Nurse Practitioner in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2022; 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.