NPIMap

Organization Active NPI

Pacific Rim Cardiovascular Inc

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Kahului, HI
National Provider Identifier
1891013199
Registry record updated Feb 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
15055 Issued in HI
Legal business name
PACIFIC RIM CARDIOVASCULAR INC
Practice address
385 Hukilike St.
Suite 210
Kahului, HI 96732
Phone
(808) 871-8346
NPI assigned
May 11, 2010
Last updated
Feb 20, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2013

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

Authorized official

Name
Dr. Robert Randolph Waterford, MDNPI 1376559203
Title
President
Phone
(808) 268-5789

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 15055 HI
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 15055 HI Primary

Addresses

Primary practice location

385 Hukilike St.
Suite 210
Kahului, HI 96732

Mailing address

PO Box 923
Wailuku, HI 96793-0923
Phone (808) 268-5789

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110728000636 HI Part B Supplier - Clinic/Group Practice 8325216732 Receives reassigned benefits from 9 practitioners
Practice locations: Hilo, HI; Kahului, HI; Kailua Kona, HI

National Provider Directory

National Provider Directory

Locations

280 Ponahawai St
Ste 101
Hilo, HI 96720
Phone (808) 885-9000

1907 S Beretania St
Ste 120
Honolulu, HI 96826
Phone (808) 952-9779

385 Hukilike St
Ste 210
Kahului, HI 96732
Phone (808) 871-8346

75-5706 Hanama Pl
Ste 208
Kailua Kona, HI 96740
Phone (808) 323-3434

65-1230 Mamalahoa Hwy
Ste C10
Kamuela, HI 96743
Phone (808) 885-9000

2435 Kaanapali Pkwy
Ste H7
Lahaina, HI 96761
Phone (808) 667-9721

305 Keawe St
#507
Lahaina, HI 96761

3214 Akahi St
Lihue, HI 96766
Phone (808) 214-5715

1939 E Vineyard St
Wailuku, HI 96793
Phone (808) 249-2431

Practitioners & affiliated clinicians

Practitioners 17

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 17

NPI Registry JSON

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

{
    "created_epoch": "1273536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361318400000",
    "number": "1891013199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 923",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967930923",
            "telephone_number": "808-268-5789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 HUKILIKE ST.",
            "address_2": "SUITE 210",
            "city": "KAHULUI",
            "state": "HI",
            "postal_code": "96732",
            "telephone_number": "808-871-8346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC RIM CARDIOVASCULAR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-11",
        "last_updated": "2013-02-20",
        "status": "A",
        "authorized_official_last_name": "WATERFORD",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "RANDOLPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "808-268-5789",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "HI",
            "license": "15055",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "HI",
            "license": "15055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kahului, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2013; 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.