Active NPI
Kohala Hospital
- Medicare Defined Swing Bed Hospital Unit
- Kapaau, HI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medicare Defined Swing Bed Hospital Unit
- License
- 17H
- Legal business name
- KOHALA HOSPITAL
- Practice address
- 54 383 Hospital Rd
Kapaau, HI 96755 - Phone
- (808) 889-6211
- Fax
- (808) 889-6978
- NPI assigned
- Dec 22, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Gino Amar
- Title
- Assistant Administrator
- Phone
- (808) 889-6211
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medicare Defined Swing Bed Hospital Unit | 275N00000X | 17H | HI | Primary |
Addresses
Primary practice location
54 383 Hospital Rd
Kapaau, HI 96755
Mailing address
PO Box 10
Kapaau, HI 96755-0010
Phone (808) 889-6211
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00006148 | Medicaid | HI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in HI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170914000591 | HI | Part A Provider - Critical Access Hospital | 0547429813 | Practice locations: Kapaau, HI |
Hospital certification: CCN 12Z302
- Legal name
- KOHALA HOSPITAL
- Organization structure
- Other
- Enrollment address
- 54-383 Hospital Rd
Kapaau, HI 96755
Related certifications (CCN) 1
Facilities connected through Provider of Services related, parent or unit certification numbers.
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
National Provider Directory
National Provider Directory- Tax ID family
- Kohala Hospital
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Critical Access Hospital
- Kapaau, HI
- NPI 1588734420
Ownership & related parties
All disclosed owners & managing parties 2
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Eugene Amar | W-2 Managing Employee | Jun 1, 2013 | 100% |
| Kohala Hospital | Operational/Managerial Control | Jun 1, 2013 | 100% |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Kohala Hospital | Hospital | Operational/Managerial Control (100%) | Jun 1, 2013 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
Facilities with the same owner 1
Facilities that share an organizational owner with 5% or greater ownership or operational control.
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Honokaa, HI
- NPI 1316910391
-
- Family Medicine Physician
- Anchorage, AK
- NPI 1790071959
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": "1166745600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1912062779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10",
"city": "KAPAAU",
"state": "HI",
"postal_code": "967550010",
"telephone_number": "808-889-6211",
"fax_number": "808-889-6978"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "54 383 HOSPITAL RD",
"city": "KAPAAU",
"state": "HI",
"postal_code": "96755",
"telephone_number": "808-889-6211",
"fax_number": "808-889-6978"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KOHALA HOSPITAL",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-22",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "AMAR",
"authorized_official_first_name": "GINO",
"authorized_official_title_or_position": "ASSISTANT ADMINISTRATOR",
"authorized_official_telephone_number": "808-889-6211",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "275N00000X",
"taxonomy_group": "",
"desc": "Medicare Defined Swing Bed Unit",
"state": "HI",
"license": "17H",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00006148",
"state": "HI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kapaau, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.