PACIFIC NEPHROLOGY LLC (NPI# 1265862221) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265862221 |
| Entity Type | Organization |
| Organization Name | PACIFIC NEPHROLOGY LLC |
| Practice Address |
95 Maui Lani Pkwy Wailuku HI 96793-2416 |
| Practice Telephone | 8082441444 |
| Practice Fax Number | 8082441445 |
| Mailing Telephone | 8082441444 |
| Mailing Fax Number | 8082441445 |
| Enumeration Date | 2013-11-12 |
| Last Update Date | 2018-03-17 |
| Authorized Official Name | JAY IAN LAKKIS (PHYSICIAN - MEMBER AND MANAGER) |
| Authorized Official Telephone | 8082441444 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
MD-12546 | HI | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| HI | 54015501 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 105 Mauilani Pkwy, Wailuku, HI 967932443 | 8082449555 | 8082449577 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932379971 | Pacific Nephrology LLC | Specialist | 95 Maui Lani Pkwy, Wailuku, HI 96793-2416 | 2008-03-05 |
| Street Address |
95 MAUI LANI PKWY |
| City | WAILUKU |
| State | HI |
| Zip Code | 96793-2416 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932379971 | Pacific Nephrology LLC | Specialist | 95 Maui Lani Pkwy, Wailuku, HI 96793-2416 | 2008-03-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699384701 | Laura Covey | Massage Therapist | Wailuku Community Acupuncture, 33 Central Ave, Wailuku, HI 96793 | 2020-07-24 |
| 1750902839 | Massage Therapy and Wellness of Hawai, LLC | Massage Therapist | Massage Therapy and Wellness of Hawaii, 219 Hookahi St Suite 108, Wailuku, HI 96793 | 2020-04-30 |
| 1790329084 | Milba Rojas Melchor | Technician | 932 Wailupe Drive, Wailuku, HI 96793 | 2019-10-30 |
| 1669973863 | Chad Adolpho | Massage Therapist | 95 Mahalani Street, Room 21, Wailuku, HI 96793 | 2018-02-22 |
| 1548785520 | Hookaulike Wellness LLC | Registered Nurse | 720 Kealii Drive, Wailuku, HI 96793 | 2017-08-10 |
| 1932585072 | Back & Body Clinic of Hi, LLC | Massage Therapist | 81 Central Avenue, Wailuku, HI 96793 | 2015-07-30 |
| 1558765719 | Maui Cancer Clinic, Inc. | Clinic/Center | 24 North Church Street Suite 308, Wailuku, HI 96793 | 2014-10-17 |
| 1609275262 | Maui Memorial Medical Center | General Acute Care Hospital | 85 Maui Lani Parkway, Wailuku, HI 96793 | 2014-08-20 |
| 1558780072 | Mental Health Kokua | Community/Behavioral Health | 503 -a Ua Place, Wailuku, HI 96793 | 2014-04-11 |
| 1538584545 | Mental Health Kokua | Assisted Living Facility | 503 Ua Pl, Iao Valley, Wailuku, Maui, HI 96793 | 2014-02-27 |
| Find all providers in zip 96793 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386901148 | Celeste Adrian M.d., LLC | Clinic/Center | 30 N Church St, Ste 300, Wailuku, HI 96793-1600 | 2012-04-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538786744 | Sharon Ohara, M.d., A Professional Corporation | Clinic/Center | 500 University Ave Apt 2005, Honolulu, HI 96826-4941 | 2020-07-03 |
| 1871910745 | Ralph A. Dupree, Md, LLC | Clinic/Center | 243 Keo Keo Road, Eleele, HI 96705 | 2014-03-27 |
| 1083035844 | Dennis H. Wachi Md LLC | Clinic/Center | 1441 Kapiolani Blvd Ste 505, Honolulu, HI 96814-4403 | 2013-12-20 |
| 1386088953 | Yoshio Oda,m.d.inc. | Clinic/Center | 1150 S King St # R00m504, Honolulu, HI 96814-1922 | 2013-04-25 |
| 1861730756 | Rosalo Molina Paeste Md Inc | Clinic/Center | 2256 N School St, Honolulu, HI 96819-2538 | 2013-01-28 |
| 1366710915 | Hilo Obstetrics and Gynecology, LLC | Clinic/Center | 670 Ponahawai St Ste 115, Hilo, HI 96720-7831 | 2011-12-11 |
| 1891099495 | American Hyperbaric Centers, Inc. | Clinic/Center | 851 Fort Street Mall Ste 100, Honolulu, HI 96813-4300 | 2010-12-22 |
| 1437451457 | R. Charles Ray, Md, LLC | Clinic/Center | 65-1227a Opelo Rd, Suite104, Kamuela, HI 96743-7315 | 2010-11-23 |
| 1386944437 | Maria Caridad Ilar-revilla Community Health Clinic LLC | Clinic/Center | 94-866 Moloalo St Ste 1b, Waipahu, HI 96797-3354 | 2010-10-22 |
| 1588843502 | Kailua Dermatology Centers of Hawaii, LLC | Clinic/Center | 1051 Keolu Dr Ste 107, Kailua, HI 96734-3800 | 2007-10-25 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.