NPIMap

Organization Active NPI

Kaiser Foundation Health Plan Inc

Doing business as Kaiser Permanente Regional Laboratory

  • Clinical Medical Laboratory
  • Honolulu, HI
National Provider Identifier
1740295393
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
12D0064446 Issued in HI
Legal business name
KAISER FOUNDATION HEALTH PLAN INC
Doing business as
Kaiser Permanente Regional Laboratory
Practice address
3288 Moanalua Rd
Honolulu, HI 96819-1469
Phone
(808) 432-8800
Fax
(808) 432-8867
NPI assigned
Jul 30, 2006
Last updated
Mar 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 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, Finance Leader
Phone
(808) 286-6758

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 12D0064446 HI Primary

Addresses

Primary practice location

3288 Moanalua Rd
Honolulu, HI 96819-1469

Mailing address

711 Kapiolani Blvd
Billing Department
Honolulu, HI 96813-5214
Phone (808) 432-5312

Other identifiers 1

IdentifierTypeStateIssuer
549959-01MedicaidHI

Other names 1

  • Kaiser Permanente Regional Laboratory Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031119000948 HI Part B Supplier - Clinic/Group Practice 1850205360 Receives reassigned benefits from 208 practitioners
31 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
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 33

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

View all 33

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
12D0064446Kaiser Permanente Moanalua Med Ctr Reg Lab3288 Moanalua Rd RM 121, Honolulu, HI 96819AccreditationFeb 27, 2027
12D0911700Kaiser Permanente Moanalua Medical Ctr PPMP3288 Moanalua Rd, Ambulatory Administration, Honolulu, HI 96819Provider-performed microscopyFeb 12, 2028
12D0918443Kaiser Permanente Moanalua Med Ctr Poc Lab3288 Moanalua Road RM 140, Honolulu, HI 96819AccreditationNov 30, 2026
12D0923870Kaiser Permanente Moanalua MC Perfusion Lab3288 Moanalua Road Tower BLDG Or, Honolulu, HI 96819AccreditationNov 17, 2027
12D1105387Kaiser Permanente Moanalua Med Ctr Hos PPMP3288 Moanalua Road, Hospital Administration, Honolulu, HI 96819Provider-performed microscopySep 21, 2027
12D2278658Kaiser Permanente MHV Laboratory3288 Moanalua Road SNF Building, Honolulu, HI 96819Certificate of waiverApr 11, 2028

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 7

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": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710288000000",
    "number": "1740295393",
    "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": "808-432-5312",
            "fax_number": "808-432-5239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3288 MOANALUA RD",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968191469",
            "telephone_number": "808-432-8800",
            "fax_number": "808-432-8867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER FOUNDATION HEALTH PLAN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR, FINANCE 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": "12D0064446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "549959-01",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kaiser Permanente Regional Laboratory",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kaiser Permanente Regional Laboratory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.