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Kaiser Foundation Health Plan, Inc.

Organization Active NPI Ambulatory Surgical Clinic/Center · Wailuku, HI

NPI 1821164476 · NPPES record last updated Nov 10, 2020

Key facts

NPI
1821164476
Entity type
Organization (NPI type 2)
Primary specialty
Ambulatory Surgical Clinic/Center 261QA1903X
License
HMF FSOF-10 (HI)
Legal business name
KAISER FOUNDATION HEALTH PLAN, INC.
Practice address
80 Mahalani St
Wailuku, HI 96793-2531
Phone
(808) 243-6000
Fax
(808) 243-6627
NPI assigned
Nov 27, 2006
Organization subpart
No

Authorized official

Name
James G. Adam Jr.
Title
Executive Director, Finance Leader
Phone
(808) 286-6758

Owned or controlled facilities with NPI records 10

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs on the same Medicare enrollment 1

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

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 23

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 107

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

View all 107

Medicare Care Compare: Ambulatory surgical center

Listed as
Kaiser Wailuku Clinic ASC CCN 12C0001100
Medicare certification status
Active (Provider of Services file)

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in HI

All facility ownership & control disclosures 7

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Kaiser Permanente Central Hospital
Seattle, WA · CCN 500052		 Hospital 5% Or Greater Indirect Ownership Interest (100%) Feb 1, 2017
Kaiser Permenante Washington Home Health
Seattle, WA · CCN 507007		 Home health agency 5% Or Greater Indirect Ownership Interest (100%) Feb 1, 2017
Kaiser Permanente Care at Home, Big Island Home Health
Kailua Kona, HI · CCN 127317		 Home health agency Operational/Managerial Control Nov 1, 2023
Kpwa Home Health & Hospice
Seattle, WA · CCN 501521		 Hospice 5% Or Greater Indirect Ownership Interest (100%) Feb 1, 2017
Kahuku Clinic
Kahuku, HI · CCN 123806		 Rural health clinic Operational/Managerial Control (100%) Jan 1, 2017
Lahaina Clinic
Lahaina, HI · CCN 123804		 Rural health clinic Operational/Managerial Control (100%) Apr 1, 2017
Kihei Clinic
Kihei, HI · CCN 123805		 Rural health clinic Operational/Managerial Control (100%) Apr 1, 2017

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040831000706 HI Part B Supplier - Ambulatory Surgical Center 1850205360 1 other NPI on this enrollment
Practice locations: Honolulu, HI; Wailuku, HI

National Provider Directory

Tax ID family
Kaiser FDN HLTH Plan Phcy (379 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X HMF FSOF-10 HI Yes

Addresses

Primary practice location

80 Mahalani St
Wailuku, HI 96793-2531

Mailing address

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

Other identifiers

IdentifierTypeStateIssuer
579451MedicaidHI

Other names

  • Kaiser Permanente Wailuku Ambulatory Surgery Center Doing business as

Other providers in Wailuku, HI

All providers in Wailuku, HI · Ambulatory Surgical Clinic/Center in Hawaii

Sources for this page

Verify at the official NPI Registry.