PSH Oahu LLC

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

Legal business name

PSH OAHU LLC

Practice address

1808 S Beretania St
Honolulu, HI 96826-1305

Phone

(808) 687-3300

Fax

(808) 973-1910

NPI assigned

Nov 8, 2022

Organization subpart

Yes

Parent organization

PACIFIC SKILLED HEALTHCARE LLCAs reported in NPPES

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

Authorized official

Name

Spencer Olsen

Title

Owner

Phone

(949) 521-0707

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in HI

Enrollment records 1

Skilled nursing facility certification: CCN 125042

Legal name

PSH OAHU LLC

Doing business as

OAHU CARE FACILITY

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Sep 14, 1995

Last certification

Aug 29, 2024

Beds

82

Ownership / control type

Corporation

Multi-facility organization

Pacific Skilled Healthcare

Organization structure

LLCProprietary

Incorporated

Jun 30, 2022 in NV

Enrollment address

1808 S Beretania St
Honolulu, HI 96826-1305

Nursing home name

OAHU CARE FACILITY

Listed as

Oahu Care FacilityCCN 125042

Overall star rating

5 of 5

Health inspections

3 of 5

Staffing

5 of 5

Quality measures

5 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Sep 14, 1995

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

8265.3 residents per day on average

Penalties (3 years)

1Fines totaling $8,278

Processed by Care Compare on Aug 1, 2026.

All disclosed owners & managing parties 8

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

Facilities with the same owner 2

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

• PSH KM LLC

  • Pediatric Skilled Nursing Facility
  • Ewa Beach, HI
  • NPI 1285342378

  Pacific Skilled Healthcare LLC

  CMS ownership
• PSH Pearl City LLC

  • Skilled Nursing Facility
  • Pearl City, HI
  • NPI 1750099834

  Pacific Skilled Healthcare LLC

  CMS ownership

Practitioners 1

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

• Robert Gries, M.D.

  • Geriatric Medicine (Family Medicine) Physician
  • Honolulu, HI
  • NPI 1669425906
  NPD (past)

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Robert Gries, M.D.

  • Geriatric Medicine (Family Medicine) Physician
  • Honolulu, HI
  • NPI 1669425906

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1667865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667865600000",
    "number": "1891403986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 LEHUA AVE",
            "city": "PEARL CITY",
            "state": "HI",
            "postal_code": "967823328",
            "telephone_number": "808-687-3224",
            "fax_number": "808-687-3209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1808 S BERETANIA ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968261305",
            "telephone_number": "808-687-3300",
            "fax_number": "808-973-1910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSH OAHU LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PACIFIC SKILLED HEALTHCARE LLC",
        "enumeration_date": "2022-11-08",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A",
        "authorized_official_last_name": "OLSEN",
        "authorized_official_first_name": "SPENCER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-521-0707"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nursing Facility/Intermediate Care Facility in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Nursing Facility/Intermediate Care Facility in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.