NPIMap

Organization Active NPI

Kau Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Pahala, HI
National Provider Identifier
1902977440
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
12Z301 Issued in HI
Legal business name
KAU HOSPITAL
Practice address
1 Kamani Street
Pahala, HI 96777
Phone
(808) 928-2050
Fax
(808) 928-8980
NPI assigned
Nov 13, 2006
Last updated
Aug 28, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
HAWAII HEALTH SYSTEMS CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Authorized official

Name
Denise Mackey
Title
Administrator
Phone
(808) 932-4102

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 12Z301 HI Primary

Addresses

Primary practice location

1 Kamani Street
Pahala, HI 96777

Mailing address

PO Box 40
Pahala, HI 96777-0040
Phone (808) 928-2050

Other identifiers 4

IdentifierTypeStateIssuer
A005064OtherHIHMSA65C ACUTE
K005062OtherHIHMSA QUEST ICF
H005069OtherHIHMSA OUTPATIENT
00567501MedicaidHI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220803002473 HI Part A Provider - Critical Access Hospital 7416945548 Practice locations: Pahala, HI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902977440. Details of each certification follow.

Hospital certification: CCN 12Z301

Legal name
KAU HOSPITAL
Organization structure
OtherNon-profit
Incorporated
Jul 1, 1998 in HI
Enrollment address
1 Kamani St
Pahala, HI 96777-0040
Hospital Swing-Bed Unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 8

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

  • Kau Hospital
    • Rural Health Clinic/Center
    • Pahala, HI
    • NPI 1144304338

    7416945548

    Same PAC ID
  • Kau Hospital

    dba East Hawaii Health Primary Care

    • Rural Health Clinic/Center
    • Hilo, HI
    • NPI 1154111607

    7416945548

    Same PAC ID
  • Kau Hospital

    dba East Hawaii Health Clinic at 1285 Waianuenue

    • Rural Health Clinic/Center
    • Hilo, HI
    • NPI 1164083374

    7416945548

    Same PAC ID
  • Kau Hospital

    dba East Hawaii Health Clinic at Pahoa

    • Rural Health Clinic/Center
    • Pahoa, HI
    • NPI 1174777916

    7416945548

    Same PAC ID
  • Kau Hospital

    dba East Hawaii Health Clinic at Puna Kai

    • Rural Health Clinic/Center
    • Pahoa, HI
    • NPI 1285450163

    7416945548

    Same PAC ID
  • Kau Hospital

    dba East Hawaii Health Clinic at 1190 Waianuenue

    • Rural Health Clinic/Center
    • Hilo, HI
    • NPI 1336789874

    7416945548

    Same PAC ID
  • Kau Hospital
    • Critical Access Hospital
    • Pahala, HI
    • NPI 1558441311

    7416945548

    Same PAC ID
  • Kau Hospital

    dba East Hawaii Health Clinic at Kea'au

    • Rural Health Clinic/Center
    • Kea'au, HI
    • NPI 1649876913

    7416945548

    Same PAC ID

National Provider Directory

National Provider Directory
Part of
Hawaii Health Systems Corporation

Ownership & related parties

All disclosed owners & managing parties 19

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

NameRoleSinceShare
Stephen M Smith Individual Corporate Director Feb 24, 2018
Daniel H Belcher Individual Corporate DirectorBoard Member Jun 1, 2020
Randall Kurohara Individual Corporate Director Feb 1, 2021
Lara Gomez Individual Corporate Director Nov 1, 2022
Jay M Ignacio Individual Corporate Director Apr 1, 2019
Yvonne Wong Individual Corporate Director Oct 1, 2022
Daniel John Brinkman Individual Corporate Director Jul 2, 2007
Rae a Yamanaka Individual Corporate Director May 17, 2016
Chad Keone Farias Individual Corporate Director Mar 1, 2021
Joseph F Skruch Individual Corporate Director Mar 15, 2022
Deanna S Sako Individual Corporate Director Sep 1, 2018
Jennifer L Zelko-Schlueter Individual Corporate Director Jul 1, 2022
Joni Mu Waltjen Individual W-2 Managing Employee Apr 23, 2001
Brenda S Ho Individual Corporate DirectorBoard Member Jul 1, 2016
Hawaii Health Systems Corporation Organization, Honolulu, HI Corporation Operational/Managerial Control Jul 1, 1996
Denise a Mackey Individual W-2 Managing Employee Feb 2, 2004
Clarysse K Nunokawa Individual Corporate Director Jun 1, 2019
Jerry L Gray Individual Corporate Director Feb 1, 2017
Linda Rosen Individual W-2 Managing EmployeeCorporate Ceo (Home Office) Dec 16, 2014

Owners & managing parties with NPI records 2

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

Facilities with the same owner 34

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

View all 34

Practitioners & affiliated clinicians

Practitioners 2

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.

Affiliated clinicians 2

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

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724803200000",
    "number": "1902977440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40",
            "city": "PAHALA",
            "state": "HI",
            "postal_code": "967770040",
            "telephone_number": "808-928-2050",
            "fax_number": "808-928-8980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KAMANI STREET",
            "city": "PAHALA",
            "state": "HI",
            "postal_code": "96777",
            "telephone_number": "808-928-2050",
            "fax_number": "808-928-8980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAU HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HAWAII HEALTH SYSTEMS CORPORATION",
        "enumeration_date": "2006-11-13",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A",
        "authorized_official_last_name": "MACKEY",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "808-932-4102"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "HI",
            "license": "12Z301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA65C ACUTE",
            "identifier": "A005064",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA QUEST ICF",
            "identifier": "K005062",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA OUTPATIENT",
            "identifier": "H005069",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00567501",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pahala, HI

Sources for this page

Verify at the official NPI Registry.