| Kipuka O Ke Ola | |
|
64-1035 Mamalaho Hwy Ste F Kamuela HI 96743-8440 | |
| (808) 885-5900 | |
| (808) 885-6900 |
| Full Name | Kipuka O Ke Ola |
|---|---|
| Speciality | Clinic/Center |
| Location | 64-1035 Mamalaho Hwy Ste F, Kamuela, Hawaii |
| Authorized Official Name and Position | Claren Kuulei Kealoha-beaudet (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 8088855900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kipuka O Ke Ola Po Box 818 Kamuela HI 96743-0818 Ph: (808) 885-5900 | Kipuka O Ke Ola 64-1035 Mamalaho Hwy Ste F Kamuela HI 96743-8440 Ph: (808) 885-5900 |
| NPI Number | 1215359989 |
|---|---|
| Provider Enumeration Date | 01/14/2014 |
| Last Update Date | 01/13/2022 |
| Certification Date | 01/13/2022 |
| Medicare PECOS PAC ID | 4880817840 |
|---|---|
| Medicare Enrollment ID | O20140520000022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215359989 | NPI | - | NPPES |
| 813669 | Medicaid | HI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Claren K Kealoha-beaudet |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003080771 PECOS PAC ID: 4082892948 Enrollment ID: I20110623000090 |
| Provider Name | Franco Acquaro |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1073842415 PECOS PAC ID: 4880841063 Enrollment ID: I20120822000622 |
| Provider Name | Natalie Ka Kong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457678351 PECOS PAC ID: 7214163534 Enrollment ID: I20141224000914 |
| Provider Name | Dara Pagaduan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457883209 PECOS PAC ID: 9436428208 Enrollment ID: I20170711000770 |
| Provider Name | Kenneth Mark Riff |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053765149 PECOS PAC ID: 4981974508 Enrollment ID: I20190625003751 |
| Provider Name | Ninu Alexandri Quirk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124321690 PECOS PAC ID: 2163731035 Enrollment ID: I20191001001151 |
| Provider Name | Steven Kwon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073765400 PECOS PAC ID: 1557530615 Enrollment ID: I20201019001825 |
| Provider Name | Michael Gordon Farnsworth |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932183274 PECOS PAC ID: 7315114642 Enrollment ID: I20210212002143 |
| Provider Name | Andrea Jean Nelsen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043442700 PECOS PAC ID: 0749423770 Enrollment ID: I20240501000293 |
Nina M. Kalckar, Lcsw Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 65-1206 Mamalahoa Hwy, Bld 2-2, Kamuela, HI 96743 Phone: 808-333-2567 | |
Serendipity Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 65-1206 Mamalahoa Hwy, Kamuela, HI 96743 Phone: 808-936-9298 | |
Big Island Psychiatry Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 65-1230 Mamalahoa Hwy, Ste D21, Kamuela, HI 96743 Phone: 253-678-5715 | |
Mauna Kea Sky Counseling Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 64-1040 Mamalahoa Hwy, Suite 202, Kamuela, HI 96743 Phone: 808-937-7323 Fax: 808-933-3601 | |
Serendipity, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 65-1206 Mamalahoa Hwy, Kamuela, HI 96743 Phone: 808-936-9298 | |
Kaiao Ola Integrative Healing, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 65-1298b Kawaihae Rd, Suite 21, Kamuela, HI 96743 Phone: 808-937-9699 Fax: 808-885-5050 |