NPIMap

Organization Active NPI

Maui Memorial Medical Center

  • Skilled Nursing Facility
  • Wailuku, HI
National Provider Identifier
1962583708
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
OHCA 69-N Issued in HI
Legal business name
MAUI MEMORIAL MEDICAL CENTER
Practice address
221 Mahalani Street
Wailuku, HI 96793
Phone
(808) 244-9056
Fax
(808) 242-2644
NPI assigned
Oct 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Wesley Lo
Title
Ceo
Phone
(808) 442-5100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X OHCA 69-N HI Primary

Addresses

Primary practice location

221 Mahalani Street
Wailuku, HI 96793

Mailing address

221 Mahalani Street
Wailuku, HI 96793
Phone (808) 244-9056

Other identifiers 2

IdentifierTypeStateIssuer
G005186OtherHISNF HMSA
00005796MedicaidHI

Other names 1

  • Skilled Nursing Facility Other name

National Provider Directory

National Provider Directory
Tax ID family
Maui Memorial Medical Center7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962583708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 MAHALANI STREET",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "96793",
            "telephone_number": "808-244-9056",
            "fax_number": "808-242-2644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 MAHALANI STREET",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "96793",
            "telephone_number": "808-244-9056",
            "fax_number": "808-242-2644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAUI MEMORIAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LO",
        "authorized_official_first_name": "WESLEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "808-442-5100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "HI",
            "license": "OHCA 69-N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SNF HMSA",
            "identifier": "G005186",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00005796",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Skilled Nursing Facility",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wailuku, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.