Kaiser Foundation Health Plan, Inc

Organization Active NPI Home Health Agency · Wailuku, HI

NPI 1962552091 · NPPES record last updated Dec 12, 2017

Key facts

NPI
1962552091
Entity type
Organization (NPI type 2)
Primary specialty
Home Health Agency 251E00000X
Legal business name
KAISER FOUNDATION HEALTH PLAN, INC
Practice address
80 Mahalani St
Wailuku, HI 96793-2531
Phone
(808) 243-6681
Fax
(808) 243-6689
NPI assigned
Jan 11, 2007
Organization subpart
No

Authorized official

Name
Daniel N. Shaw
Title
Chief Financial Officer
Phone
(808) 432-5272

Owners & managing parties with NPI records 2

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

Owned or controlled facilities with NPI records 10

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs with the same Medicare PAC ID 7

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

Corporate family (same tax ID) 15

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

Member organizations 9

Organizations listed as members of this organization in the National Provider Directory.

Facilities with the same owner 78

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

View all 78

Practitioners 108

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

View all 108

Affiliated clinicians 1

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

Medicare Care Compare: Home health agency

Listed as
Kaiser Permanente Home Health Agency Maui CCN 127023
Overall star rating
★★★☆☆ 3 of 5
Ownership
Non-Profit
Certified
Oct 11, 1993
Medicare certification status
Active (Provider of Services file)
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in HI

Home health agency certification: CCN 127023

Legal name
KAISER FOUNDATION HEALTH PLAN INC
Doing business as
KAISER PERMANENTE HOME HEALTH AGENCY MAU
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Oct 11, 1993
Last certification
Mar 15, 2019
Ownership / control type
Non-Profit
Organization structure
Corporation · Non-profit
Incorporated
Mar 11, 1955 in CA
Enrollment address
80 Mahalani St
FL 2
Wailuku, HI 96793-2531

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
David J Barger
Individual
Corporate Director
Board Member
Nov 11, 2019
Margaret E Porfido
Individual
Corporate Director
Board Member
Nov 1, 2011 100%
Jenny Ming
Individual
Corporate Director
Board Member
Jul 6, 2021
Richard P Shannon
Individual
Corporate Director
Board Member
Jul 1, 2014 100%
Regina M Benjamin
Individual
Corporate Director
Board Member
Jun 1, 2015 100%
Michelle J Gaskill-Hames
Individual
Corporate Officer
Regional President
Sep 18, 2023
Judith a Johansen
Individual
Corporate Director
Board Member
Apr 1, 2006 100%
Pamela D Hope
Individual
Contracted Managing Employee
Medical Director
Nov 1, 2009 100%
Corporate Director Nov 1, 2009
Douglas a Lemieux
Individual
W-2 Managing Employee
Sr Director
Jul 8, 2018
David F Hoffmeister
Individual
Corporate Director
Board Member
Nov 1, 2014 100%
Kaiser Foundation Hospitals
Organization · Oakland, CA
Corporation, Non-profit
Operational/Managerial Control Jan 1, 1966
Arnold Eugene Washington
Individual
Corporate Director
Board Member
Jan 4, 2016 100%
Ines Gaeta
Individual
Operational/Managerial Control
Controller & Executive Director
Apr 4, 2022
James Adams
Individual
Corporate Officer
Exec Dir Finance, Hawaii Market
Sep 19, 2022
W-2 Managing Employee
Exec Dir Finance, Hawaii Market
Sep 19, 2022
Jeffrey E Epstein
Individual
Corporate Director
Board Member
Apr 1, 2013 100%
Ramon F Baez
Individual
Corporate Director
Board Member
Jun 4, 2016 100%
Gregory a Adams
Individual
Corporate Officer
Chairman and Ceo
Nov 11, 2019
Corporate Director
Chairman and Ceo
Nov 11, 2019
Matthew T Ryan
Individual
Corporate Director
Board Member
Jan 1, 2020
Leslie S Heisz
Individual
Corporate Director
Board Member
Jan 1, 2015 100%

All facility ownership & control disclosures 7

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Kaiser Permanente Central Hospital
Seattle, WA · CCN 500052
Hospital 5% Or Greater Indirect Ownership Interest (100%) Feb 1, 2017
Kaiser Permenante Washington Home Health
Seattle, WA · CCN 507007
Home health agency 5% Or Greater Indirect Ownership Interest (100%) Feb 1, 2017
Kaiser Permanente Care at Home, Big Island Home Health
Kailua Kona, HI · CCN 127317
Home health agency Operational/Managerial Control Nov 1, 2023
Kpwa Home Health & Hospice
Seattle, WA · CCN 501521
Hospice 5% Or Greater Indirect Ownership Interest (100%) Feb 1, 2017
Kahuku Clinic
Kahuku, HI · CCN 123806
Rural health clinic Operational/Managerial Control (100%) Jan 1, 2017
Lahaina Clinic
Lahaina, HI · CCN 123804
Rural health clinic Operational/Managerial Control (100%) Apr 1, 2017
Kihei Clinic
Kihei, HI · CCN 123805
Rural health clinic Operational/Managerial Control (100%) Apr 1, 2017

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20090605000468 HI Part a Provider - Home Health Agency 1850205360 Practice locations: Wailuku, HI

National Provider Directory

Tax ID family
Kaiser FDN HLTH Plan Phcy (379 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Yes

Addresses

Primary practice location

80 Mahalani St
Wailuku, HI 96793-2531

Mailing address

711 Kapiolani Blvd
Honolulu, HI 96813-5237

Other providers in Wailuku, HI

All providers in Wailuku, HI · Home Health Agency in Hawaii

Sources for this page

Verify at the official NPI Registry.