NPIMap

Organization Active NPI

Kaiser Foundation Health Plan, Inc

Doing business as Lahaina Clinic

  • Rural Health Clinic/Center
  • Lahaina, HI
National Provider Identifier
1831630920
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
KAISER FOUNDATION HEALTH PLAN, INC
Doing business as
Lahaina Clinic
Practice address
910 Wainee St
Lahaina, HI 96761-1622
Phone
(808) 243-6000
NPI assigned
Mar 9, 2017
Last updated
Feb 1, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
KAISER FOUNDATION HEALTH PLAN, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

910 Wainee St
Lahaina, HI 96761-1622

Mailing address

711 Kapiolani Blvd
Honolulu, HI 96813-5237
Phone (808) 432-5340

Other names 1

  • Lahaina Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170403000437 HI Part A Provider - Rural Health Clinic 1850205360 Practice locations: Lahaina, HI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1831630920. Details of each certification follow.

Rural health clinic certification: CCN 123804

Legal name
KAISER FOUNDATION HEALTH PLAN INC
Doing business as
LAHAINA CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Oct 5, 2017
Last certification
Jul 21, 2021
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Mar 15, 1995 in CA
Enrollment address
2301 Kaanapali Pkwy
Lahaina, HI 96761-1908

Other NPIs with the same Medicare PAC ID 7

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

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
12D2299283Kaiser Permanente Lahaina Clinic PPMP2301 Kaanapali Parkway Administration, Lahaina, HI 96761Provider-performed microscopyFeb 15, 2028

National Provider Directory

National Provider Directory
Tax ID family
Kaiser Foundation HLTH379 organizations share this tax ID, including this one
Part of
Kaiser Foundation HLTH

Organizations with this tax ID in the same state 21

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 21

Locations

910 Wainee St
Lahaina, HI 96761
Phone (808) 243-6000

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
David J Barger Individual Corporate DirectorBoard Member May 1, 2016
Margaret E Porfido Individual Corporate DirectorBoard Member Nov 1, 2011
Kaiser Foundation Health Plan Inc Organization, Oakland, CA Corporation, Non-profit Operational/Managerial Control Apr 1, 2017 100%
Jenny Ming Individual Corporate DirectorBoard Member Jul 6, 2021
Richard P Shannon Individual Corporate DirectorBoard Member Jul 1, 2014
Regina M Benjamin Individual Corporate DirectorBoard Member Jun 1, 2015
Michelle J Gaskill-Hames Individual Corporate OfficerRegional President, Hawaii Sep 18, 2023
Judith a Johansen Individual Corporate DirectorBoard Member Apr 1, 2006
Douglas a Lemieux Individual W-2 Managing EmployeeSr Director Jul 8, 2018
David F Hoffmeister Individual Corporate DirectorBoard Member Nov 1, 2014
Arnold Eugene Washington Individual Corporate DirectorBoard Member Jan 4, 2016
Ines Gaeta Individual Operational/Managerial ControlController & Executive Director Apr 4, 2022
James Adams Individual Corporate OfficerExec Dir Finance, Hawaii Market Sep 19, 2022
W-2 Managing EmployeeExec Dir Finance, Hawaii Market Sep 19, 2022
Jeffrey E Epstein Individual Corporate DirectorBoard Member Apr 1, 2013
Ramon F Baez Individual Corporate DirectorBoard Member Jun 4, 2016
Gregory a Adams Individual Corporate DirectorBoard Member Feb 25, 2020
Matthew T Ryan Individual Corporate DirectorBoard Member Jan 1, 2020
Leslie S Heisz Individual Corporate DirectorBoard Member Jan 1, 2015

Owners & managing parties with NPI records 8

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

All facility ownership & control disclosures 6

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

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

Owned or controlled facilities with NPI records 9

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

Facilities with the same owner 6

Facilities that share an organizational owner with 5% or greater ownership or operational control.

NPI Registry JSON

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

{
    "created_epoch": "1489017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706745600000",
    "number": "1831630920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 KAPIOLANI BLVD",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968135237",
            "telephone_number": "808-432-5340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 WAINEE ST",
            "city": "LAHAINA",
            "state": "HI",
            "postal_code": "967611622",
            "telephone_number": "808-243-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER FOUNDATION HEALTH PLAN, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KAISER FOUNDATION HEALTH PLAN, INC",
        "enumeration_date": "2017-03-09",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "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_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lahaina Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lahaina Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lahaina, HI

Sources for this page

Verify at the official NPI Registry.