Individual provider Active NPI

Coleen Marie Haynes, M.D.

  • Family Medicine Physician
  • Kahului, HI
National Provider Identifier
1700059417
Registry record updated May 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
14467 Issued in HI
Practice address
415 Dairy Rd # 320
Kahului, HI 96732-2348
Phone
(808) 264-7584
NPI assigned
Apr 2, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 7741A WY
Family Medicine Physician 207Q00000X M-2529 GU
Family Medicine Physician 207Q00000X MTL-2026-006 GU
Family Medicine Physician 207Q00000X 14467 HI Primary

Addresses

Primary practice location

415 Dairy Rd # 320
Kahului, HI 96732-2348

Mailing address

415 Dairy Rd # 320
Kahului, HI 96732-2348
Phone (808) 264-7584

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI, VI, GU3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20080610000563 HI Practitioner - Family Practice 0941370415 Reassigns benefits to 2 organizations
I20241029004533 VI Practitioner - Internal Medicine 0941370415 Reassigns benefits to 1 organization
I20260402002149 GU Practitioner - Hospitalist 0941370415 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

133 Route 3
Dededo, GU 96929-6911
Phone (671) 645-5500

4007 Estate Diamond Ruby
Christiansted, VI 00820-4435
Phone (340) 778-6311

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M-2529GUMDFamily Medicine Physician
MTL-2026-006GUMDFamily Medicine Physician
14467HIMDFamily Medicine Physician
7741AWYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Governor Juan F. Luis Hospital & Medical Center CurrentSince Oct 9, 2024 Accepting new patients
Quantum Healthcare Medical Associates Inc. Family Medicine CurrentSince Oct 1, 2015 Accepting new patients
Governor Juan F. Luis Hospital & Medical Center CurrentSince Oct 9, 2024 Accepting new patients
Hawaii Emergency Physicians Associated Inc Past Accepting new patients

Locations

1190 Waianuenue Ave
Hilo, HI 96720
Phone (808) 932-3000

4007 Estate Diamond Ruby
St Croix, VI 00820
Phone (340) 772-7423

Interoperability endpoints

  • Direct secure messaging: coleen.haynes@490562416214020.direct.elationemr.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1207094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779926400000",
    "number": "1700059417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 DAIRY RD # 320",
            "city": "KAHULUI",
            "state": "HI",
            "postal_code": "967322348",
            "telephone_number": "808-264-7584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 DAIRY RD # 320",
            "city": "KAHULUI",
            "state": "HI",
            "postal_code": "967322348",
            "telephone_number": "808-264-7584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "COLEEN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-02",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WY",
            "license": "7741A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GU",
            "license": "M-2529",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GU",
            "license": "MTL-2026-006",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "HI",
            "license": "14467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kahului, HI

Sources for this page

Verify at the official NPI Registry.