NPIMap

Organization Active NPI

Kaiser Foundation Health Plan, Inc.

Doing business as Kaiser Pearlridge Clinic Laboratory

  • Clinical Medical Laboratory
  • Aiea, HI
National Provider Identifier
1992122659
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
12D2060559 Issued in HI
Legal business name
KAISER FOUNDATION HEALTH PLAN, INC.
Doing business as
Kaiser Pearlridge Clinic Laboratory
Practice address
98-1005 Moanalua Rd
Suite 1000
Aiea, HI 96701-4777
Phone
(808) 432-5849
NPI assigned
Mar 19, 2014
Last updated
Jan 31, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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

Authorized official

Name
James G. Adams Jr.
Title
Executive Director, Finance Leader
Phone
(808) 286-6758

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 12D2060559 HI Primary

Addresses

Primary practice location

98-1005 Moanalua Rd
Suite 1000
Aiea, HI 96701-4777

Mailing address

711 Kapiolani Blvd
Honolulu, HI 96813-5237
Phone (808) 432-5340

Other names 1

  • Kaiser Pearlridge Clinic Laboratory Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031119000948 HI Part B Supplier - Clinic/Group Practice 1850205360 Receives reassigned benefits from 208 practitioners
31 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 31

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 31

National Provider Directory

National Provider Directory
Tax ID family
Kaiser Foundation HLTH379 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 13

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 13

Locations

75 Maui Lani Pkwy
Wailuku, HI 96793
Phone (808) 243-6000

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1395187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706659200000",
    "number": "1992122659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 KAPIOLANI BLVD",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968135237",
            "telephone_number": "808-432-5340",
            "fax_number": "808-432-5349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98-1005 MOANALUA RD",
            "address_2": "SUITE 1000",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967014777",
            "telephone_number": "808-432-5849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER FOUNDATION HEALTH PLAN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-19",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR, FINANCE LEADER",
        "authorized_official_telephone_number": "808-286-6758",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "HI",
            "license": "12D2060559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kaiser Pearlridge Clinic Laboratory",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kaiser Pearlridge Clinic Laboratory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Aiea, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.