NPIMap

Organization Active NPI

Maui Kidney Center LLC

  • Nephrology Physician
  • Wailuku, HI
National Provider Identifier
1770054355
Registry record updated Apr 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
MAUI KIDNEY CENTER LLC
Practice address
105 Maui Lani Pkwy
Wailuku, HI 96793-2443
Phone
(480) 740-2106
NPI assigned
Dec 7, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2019

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

Authorized official

Name
Dr. Antonin Jaros, MD
Title
Owner
Phone
(480) 740-2106

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

105 Maui Lani Pkwy
Wailuku, HI 96793-2443

Mailing address

105 Maui Lani Pkwy Ste 100
Wailuku, HI 96793-2443
Phone (480) 740-2106

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1544140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554508800000",
    "number": "1770054355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 MAUI LANI PKWY STE 100",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967932443",
            "telephone_number": "480-740-2106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 MAUI LANI PKWY",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967932443",
            "telephone_number": "480-740-2106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAUI KIDNEY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-07",
        "last_updated": "2019-04-06",
        "status": "A",
        "authorized_official_last_name": "JAROS",
        "authorized_official_first_name": "ANTONIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-740-2106",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.