NPIMap

Organization Active NPI

Pali Momi Medical Center

Doing business as Pali Momi Medical Center Outpatient Pharmacy

  • Community/Retail Pharmacy
  • Aiea, HI
National Provider Identifier
1851364731
Registry record updated Nov 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
PALI MOMI MEDICAL CENTER
Doing business as
Pali Momi Medical Center Outpatient Pharmacy
Practice address
98 1079 Moanalua Rd
Mob Suite 150
Aiea, HI 96701
Phone
(808) 840-5660
Fax
(808) 485-1700
NPI assigned
Feb 9, 2006
Last updated
Nov 29, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
PALI MOMI MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 29, 2022

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

Authorized official

Name
David Y Okabe
Title
Evp & Cfo
Phone
(808) 535-7202

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

98 1079 Moanalua Rd
Mob Suite 150
Aiea, HI 96701

Mailing address

98-1079 Moanalua Rd Ste 150
Aiea, HI 96701-4714
Phone (808) 840-5660

Other names 1

  • Pali Momi Medical Center Outpatient Pharmacy Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20230126000367 HI Part B Supplier - Pharmacy 6406746916 Practice locations: Aiea, HI
O20230331000980 HI DME Supplier - Pharmacy 6406746916 Practice locations: Aiea, HI

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
Kapiolani Medical Center at4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

98-1079 Moanalua Rd
Ste 150
Aiea, HI 96701
Phone (808) 835-6190

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 137

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.

View all 137

NPI Registry JSON

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669680000000",
    "number": "1851364731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98-1079 MOANALUA RD STE 150",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967014714",
            "telephone_number": "808-840-5660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98 1079 MOANALUA RD",
            "address_2": "MOB SUITE 150",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "96701",
            "telephone_number": "808-840-5660",
            "fax_number": "808-485-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALI MOMI MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PALI MOMI MEDICAL CENTER",
        "enumeration_date": "2006-02-09",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A",
        "authorized_official_last_name": "OKABE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "EVP & CFO",
        "authorized_official_telephone_number": "808-535-7202"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pali Momi Medical Center Outpatient Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Aiea, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.