NPIMap

Organization Active NPI

Waianae District Comprehensive Health and Hospital Board, Incorporated

Doing business as Waianae Coast Comprehensive Health Center

  • Federally Qualified Health Center (FQHC)
  • Waianae, HI
National Provider Identifier
1992730956
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
WAIANAE DISTRICT COMPREHENSIVE HEALTH AND HOSPITAL BOARD, INCORPORATED
Doing business as
Waianae Coast Comprehensive Health Center
Practice address
86-260 Farrington Hwy
Waianae, HI 96792-3128
Phone
(808) 696-7081
Fax
(808) 696-7093
NPI assigned
Jul 11, 2006
Last updated
Mar 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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

Authorized official

Name
Cindy Yee
Title
Chief Financial Officer
Phone
(808) 697-3128

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU
Emergency Care Clinic/Center 261QE0002X NU
Non-Surgical Family Planning Clinic/Center 261QF0050X NU
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Multi-Specialty Clinic/Center 261QM1300X NU
Primary Care Clinic/Center 261QP2300X NU
Urgent Care Clinic/Center 261QU0200X NU

Addresses

Primary practice location

86-260 Farrington Hwy
Waianae, HI 96792-3128

Mailing address

86-260 Farrington Hwy
Waianae, HI 96792-3128
Phone (808) 696-3300

Other identifiers 1

IdentifierTypeStateIssuer
00934901MedicaidHI

Other names 1

  • Waianae Coast Comprehensive Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070216000692 HI Part A Provider - Federally Qualified Health Center (FQHC) 9931008349 Practice locations: Waianae, HI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1992730956. Details of each certification follow.

Federally qualified health center certification: CCN 121801

Legal name
WAIANAE DISTRICT COMPREHENSIVE HEALTH AND HOSPITAL BOARD INCORPORATED
Doing business as
WAIANAE COAST COMPREHENSIVE HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 1, 1991
Last certification
Oct 1, 1991
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 6, 1969 in HI
Enrollment address
86-260 Farrington Hwy
Waianae, HI 96792-3128

Other NPIs with the same Medicare PAC ID 16

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

View all 16

National Provider Directory

National Provider Directory
Tax ID family
Waianae Coast Comprehensive39 organizations share this tax ID, including this one

Other organizations with this tax ID 38

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

View all 38

Ownership & related parties

All disclosed owners & managing parties 22

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

NameRoleSinceShare
Genevieve Aken Individual Corporate Director May 19, 2020
Dane K Lloyd Individual Corporate Director May 5, 2012
Charles Hew-Len Individual Corporate Director May 18, 2015
Clifford K Isara Individual Corporate Director Nov 15, 2007
Desire de Soto Individual Corporate Director May 21, 2024
Richard P Bettini Individual Corporate OfficerPresident & Ceo Feb 9, 1979
W-2 Managing EmployeePresident & Ceo Sep 22, 2014
Operational/Managerial ControlPresident & Ceo Feb 9, 1979
Marianne Glushenko Individual Corporate Director May 21, 2024
Lajuaine C Suiso Individual Corporate Director Nov 15, 2007
Merrie L Aipoalani Individual Corporate Director Nov 15, 2007
Denice Keliikoa Individual Corporate Director May 18, 2015
Deroy Lavatai Individual Corporate Director May 16, 2023
Anthony Paris Individual Corporate Director Jul 25, 2023
Billie J Hauge Individual Corporate Director Mar 17, 2014
Tesha Malama Individual Corporate Director May 17, 2022
Judith Babson Individual Corporate Director May 21, 2018
Todd Nitta Individual Corporate Director Apr 20, 2021
Cindy Yee Individual Corporate Director Jun 30, 2022
W-2 Managing EmployeeChief Financial Officer Nov 25, 2019
Virginia M Fuata Individual Corporate Director Nov 15, 2007
Renee J Rego Individual Corporate Director May 18, 2015
Florine D Pell Individual Corporate Director May 18, 2015
Wayne K Suehiro Individual Corporate Director Nov 15, 2007
Daniel H Gomes Individual Corporate Director Nov 15, 2007

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
The Comp at Tamura Super MarketWaianae, HI, CCN 121878 Federally qualified health center Operational/Managerial Control May 6, 1969
Makaha HealthWaianae, HI, CCN 121021 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1972

Owned or controlled facilities with NPI records 2

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

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742342400000",
    "number": "1992730956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86-260 FARRINGTON HWY",
            "city": "WAIANAE",
            "state": "HI",
            "postal_code": "967923128",
            "telephone_number": "808-696-3300",
            "fax_number": "808-696-7093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86-260 FARRINGTON HWY",
            "city": "WAIANAE",
            "state": "HI",
            "postal_code": "967923128",
            "telephone_number": "808-696-7081",
            "fax_number": "808-696-7093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAIANAE DISTRICT COMPREHENSIVE HEALTH AND HOSPITAL BOARD, INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A",
        "authorized_official_last_name": "YEE",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "808-697-3128"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Family Planning, Non-Surgical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00934901",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Waianae Coast Comprehensive Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Waianae Coast Comprehensive Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waianae, HI

Sources for this page

Verify at the official NPI Registry.