Waimanalo Health Center

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

WAIMANALO HEALTH CENTER

Practice address

41-1347 Kalanianaole Hwy
Waimanalo, HI 96795-1247

Phone

(808) 954-7107

Fax

(808) 259-6449

NPI assigned

Jan 23, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Mary Oneha, APRN, PHD, FAAN

Title

Chief Executive Officer

Phone

(808) 954-7107

Specialties & licenses 2

Addresses

Other identifiers 14

Medicare fee-for-service enrollment

Enrolled in HI4 enrollments

Enrollment records 4

Federally qualified health center certification: CCN 121806

Legal name

WAIMANALO HEALTH CENTER

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

May 1, 1995

Last certification

May 1, 1995

Ownership / control type

For profit – partnership

Organization structure

CorporationNon-profit

Incorporated

Jan 25, 1989 in HI

Enrollment address

41-1347 Kalanianaole Hwy
Waimanalo, HI 96795-1247

Federally qualified health center certification: CCN 121868

Legal name

WAIMANALO HEALTH CENTER

Doing business as

WAIMANALO HEALTH CENTER

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Mar 28, 2019

Last certification

Mar 28, 2019

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Jan 25, 1989 in HI

Enrollment address

41-1295 Kalanianaole Hwy
Waimanalo, HI 96795-1247

Federally qualified health center certification: CCN 121017

Legal name

WAIMANALO HEALTH CENTER

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Dec 5, 2024

Last certification

Dec 5, 2024

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Enrollment address

41-1330 Kalanianaole Hwy
Waimanalo, HI 96795-1214

Locations

All disclosed owners & managing parties 21

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Christina K. Lee, MD

  • Family Medicine Physician
  • Waipahu, HI
  • NPI 1538244058

  Corporate Officer, W-2 Managing Employee

  CMS ownership

Practitioners 48

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

• Robert Aki

  • Podiatrist
  • Honolulu, HI
  • NPI 1710083944

  HI

  Medicare reassignment Care Compare group NPD
• Amy Condon, FNP

  • Family Nurse Practitioner
  • Ewa Beach, HI
  • NPI 1952723843

  HI

  Medicare reassignment Care Compare group NPD
• Jennifer Conway, RD

  • Health Educator
  • Waimanalo, HI
  • NPI 1508526757

  HI

  Medicare reassignment Care Compare group NPD
• Rose Evelyn Friedheim

  • Clinical Psychologist
  • Honolulu, HI
  • NPI 1568868636

  HI

  Medicare reassignment Care Compare group NPD
• Edy Kaleimomi Gomes, MD

  • Family Medicine Physician
  • Waimanalo, HI
  • NPI 1336717537

  HI

  Medicare reassignment Care Compare group NPD
• Isidro Paul Hermosura, PSY.D.

  • Clinical Psychologist
  • Waimanalo, HI
  • NPI 1831345149

  HI

  Medicare reassignment Care Compare group NPD
• Darcy Siu Fah Ing

  • Clinical Psychologist
  • Honolulu, HI
  • NPI 1821036252

  HI

  Medicare reassignment Care Compare group NPD
• Jun Kauh, APRN

  • Family Nurse Practitioner
  • Honolulu, HI
  • NPI 1043081425

  HI

  Medicare reassignment Care Compare group NPD
• Christina K. Lee, MD

  • Family Medicine Physician
  • Waipahu, HI
  • NPI 1538244058

  HI

  Medicare reassignment Care Compare group NPD
• Jin Song Lee, DO

  • Psychiatry Physician
  • Waianae, HI
  • NPI 1508492448

  HI

  Medicare reassignment Care Compare group NPD
• Maria O Moreno-Chow, APRN, FNP-BC

  • Family Nurse Practitioner
  • Waimanalo, HI
  • NPI 1104859263

  HI

  Medicare reassignment Care Compare group NPD
• Kalamaoka Aina K S Niheu

  • Family Medicine Physician
  • Waimanalo, HI
  • NPI 1487756235

  HI

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603324800000",
    "number": "1780738005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41-1347 KALANIANAOLE HWY",
            "city": "WAIMANALO",
            "state": "HI",
            "postal_code": "967951247",
            "telephone_number": "808-954-7107",
            "fax_number": "808-259-6449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41-1347 KALANIANAOLE HWY",
            "city": "WAIMANALO",
            "state": "HI",
            "postal_code": "967951247",
            "telephone_number": "808-954-7107",
            "fax_number": "808-259-6449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAIMANALO HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A",
        "authorized_official_last_name": "ONEHA",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "808-954-7107",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "APRN, PHD, FAAN"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "HI",
            "license": "W20416724-01",
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "049587",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUES - CUMMINGS",
            "identifier": "00C0238901",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA PPO - BHATTACHARYYA",
            "identifier": "00D0094351",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUES - CHAN",
            "identifier": "00A0080927",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUES - BHATTACHARYYA",
            "identifier": "00D0094351",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04958701",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0054794522",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUES - HATAKEYAMA",
            "identifier": "0000212407",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000228100",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0007253302",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0055795200",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA - AGULLANA",
            "identifier": "00D0245664",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0006095000",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUES - AGULLANA",
            "identifier": "00D0245664",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dana Kanani Uchibori
• Laura Vanhorn, RBT
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• Waimanalo Health Center
• Waimanalo Health Center
• Waimanalo Health Center
• Waimanalo Pharmacy Inc
• Rhonda Linne Waldinger, L.AC.
• We the Well Beings, LLC
• Antoinette Kaleiwohiokalani Whittington, MSCP, LMHC

• All providers in Waimanalo, HI
• Federally Qualified Health Center (FQHC) in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.