TRIPLER ARMY MEDICAL CENTER (NPI# 1275781171) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1275781171 |
Entity Type | Organization |
Organization Name | TRIPLER ARMY MEDICAL CENTER |
Other Organization Name | POHAKULOA TMC |
Practice Address |
1 Jarrett White Rd Honolulu HI 96859 |
Mailing Address |
1 Jarrett White Rd Attn Pad Mchk-pat-t Tripler Army Medical Center HI 96859-5001 |
Practice Telephone | 8089692411 |
Mailing Telephone | 8084336103 |
Enumeration Date | 2008-09-04 |
Last Update Date | 2014-03-19 |
Authorized Official Name | HUGH KEEL (UBO MANAGER) |
Authorized Official Telephone | 8084331016 |
Is Organization Subpart | Y |
Parent Organization Name | TRIPLER ARMY MEDICAL CENTER |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QM1100X |
Clinic/Center Specialization: Military/U.S. Coast Guard Outpatient |
Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
POHAKULOA TMC | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114230109 | Tripler Army Medical Center | Clinic/Center | 91-1010 Shangrila St, Suite 100, Kapolei, HI 96707-2161 | 2010-07-19 |
1538365036 | Tripler Army Medical Center | Clinic/Center | Bldg 660 Mccornack Road, Dental Clinic, Schofield Barracks, HI 96857 | 2007-06-22 |
1750599403 | Tripler Army Medical Center | Clinic/Center | Mccornack Rd Bldg 677, Schofield Barracks, HI 96857 | 2007-05-18 |
1841408598 | Tripler Army Medical Center | Clinic/Center | Mccornack Rd Bldg 682, Schofield Barracks, HI 96857 | 2007-05-18 |
1558460238 | Tripler Army Medical Center | Military/U.S. Coast Guard Pharmacy | Bldg 676, Schofield Barracks, HI 96857-5460 | 2006-09-21 |
1427157056 | Tripler Army Medical Center | Military/U.S. Coast Guard Pharmacy | Sand Island Access Rd Area 4, Honolulu, HI 96819 | 2006-09-21 |
1245628056 | Tripler Army Medical Center | Military/U.S. Coast Guard Pharmacy | 91-1010 Shangrila St Ste 100, Kapolei, HI 96707-2176 | 2014-12-31 |
1972919348 | Tripler Army Medical Center | Military/U.S. Coast Guard Pharmacy | Bldg 676, Schofield Barracks, HI 96857-5460 | 2014-07-07 |
1629482062 | Tripler Army Medical Center | Military/U.S. Coast Guard Pharmacy | 755 Scott Cir, Hickam Afb, HI 96853-5399 | 2014-06-13 |
1902218423 | Tripler Army Medical Center | Military/U.S. Coast Guard Pharmacy | 1 Jarrett White Rd, Tripler Army Medical Center, Tripler Amc, HI 96859-5001 | 2014-06-02 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | TRIPLER ARMY MEDICAL CENTER | 1 Jarrett White Rd, Tripler Army Medical Center, HI 96859-5001 |
Street Address |
1 JARRETT WHITE RD |
City | HONOLULU |
State | HI |
Zip Code | 96859 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588295935 | Christina Alison Lewis | Registered Nurse | 1 Jarrett White Rd, Tripler Army Medical Center Pain Clinic 9th Floor Cwing, Honolulu, HI 96859-5000 | 2020-02-03 |
1770093650 | Matthew Reggio | Nurse Anesthetist, Certified Registered | 1 Jarrett White Rd, Honolulu, HI 96259 | 2017-10-05 |
1477980878 | Jonathan Su | Physical Therapist | 1 Jarrett White Rd, Attn: Physical Therapy, Honolulu, HI 96859 | 2013-09-30 |
1285900712 | Kawika Alex Maskell | Physician Assistant | 1 Jarrett White Rd, Honolulu, HI 96789 | 2012-03-29 |
1184869141 | Cristian Samuel Madar | Internal Medicine | 1 Jarrett White Rd, Honolulu, HI 96859 | 2008-12-04 |
1881840759 | Richelle Miki Cardwell | Pharmacist | 1 Jarrett White Rd, Honolulu, HI 96819-0002 | 2008-08-12 |
1629237961 | Michael Jonathan Keiji Shigemasa | Anesthesiology | 1 Jarrett White Rd, Honolulu, HI 96859-5001 | 2008-06-02 |
1083813901 | Joseph Sterbis | Urology | 1 Jarrett White Rd, Urology Clinic, Honolulu, HI 96822 | 2007-07-11 |
1508060161 | Ryan Fitz Gibbons | Anesthesiology | 1 Jarrett White Rd, Dept of Anesthesiology, Honolulu, HI 96859-5000 | 2007-06-14 |
1528278074 | Eleane Marie Beadle | Pediatrics | 1 Jarrett White Rd, Tripler Army Medical Center, Honolulu, HI 96859-5001 | 2007-05-23 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770115792 | The Janz Corporation | Durable Medical Equipment & Medical Supplies | Tripler Medical Center, C-103, Honolulu, HI 96859 | 2020-02-07 |
1467726927 | Elton E Bacon | Orthotist | 1 Jarrett White Rd Dept of The Army, Attn: Orthopedic Brace Clinic (mchk-dso-a), Tripler Amc, HI 96859 | 2012-03-01 |
1063738813 | Defense Finance & Actg Service | Military Hospital | 691 Schofield Barracks, U.s Army Health Clinic Bldg, Wahiawa, HI 96859 | 2010-04-19 |
1972737153 | Kyong Su Min | Orthopaedic Surgery | 1 Jarrett White Rd Bldg 4f, Tripler Army Medical Center, HI 96859 | 2009-05-04 |
1558503854 | Mark Andrew Gerum | Social Worker | Tripler Army Medical Center, 1 Jarrett White Road, Intensive Outpatient Program (iop), Honolulu, HI 96859 | 2009-04-01 |
1578720926 | Travis Jaya Mason | Surgery | Tripler Army Medical Center 1 Jarrett White Road, Honolulu, HI 96859 | 2008-05-21 |
1467513168 | Joselyn Cabalo Funtanilla Ponce | Registered Nurse | 1 Jarrett White Rd Bldg 4, Tripler Amc, HI 96859 | 2006-12-13 |
1346280195 | Harkirtin Kaur Mciver | Pediatrics | Tripler Army Medical Center Mchk-pe, 1 Jarrett White Road, Honolulu, HI 96859 | 2006-06-08 |
1043297740 | Jacqueline Seger | Registered Nurse | Tamc 1 Jarrett-white Rd., 1 Jarrett-white Rd. / Mchk-dsc, Honolulu, HI 96859 | 2005-12-23 |
1982694683 | Peter Marlin | Psychiatry & Neurology | Tamc, 1 Jarriet White Road, Honolulu, HI 96859 | 2005-10-24 |
Find all providers in zip 96859 |
Taxonomy Code | 261QM1100X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Military/U.S. Coast Guard Outpatient |
The Defense Health Program or U.S. Coast Guard funded "fixed" facilities or distinct parts of a facility, providing outpatient medical and dental services, primarily for Uniformed Services beneficiaries. A "fixed" facility is a non-temporary, non-deployed facility. It includes mobile specialty units such as Magnetic Resonance Imaging (MRI) units that may furnish services at the "fixed" facility. It includes, as examples, the institutional portion of outpatient encounters (except Ambulatory Procedure Visits), supplies issued (e.g., glasses, ostomy supplies, crutches), and radiology and laboratory studies. Does not include items issued directly to a patient from an outpatient pharmacy or patient transport. |
Notes: Source: TRICARE Management Activity Uniform Business Office User’s Guide [1/1/2005: title modified, definition added; 7/1/2006 title modified, definition modified] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316029259 | U.S. Coast Guard Isc Honolulu | Clinic/Center | 400 Sand Island Pkwy, Health Services Division, Honolulu, HI 96819-4326 | 2006-10-19 |
1831146281 | Tripler Army Medical Center | Clinic/Center | 1 Jarrett White Rd, Honolulu, HI 96859-5000 | 2006-05-30 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114230109 | Tripler Army Medical Center | Clinic/Center | 91-1010 Shangrila St, Suite 100, Kapolei, HI 96707-2161 | 2010-07-19 |
1538365036 | Tripler Army Medical Center | Clinic/Center | Bldg 660 Mccornack Road, Dental Clinic, Schofield Barracks, HI 96857 | 2007-06-22 |
1750599403 | Tripler Army Medical Center | Clinic/Center | Mccornack Rd Bldg 677, Schofield Barracks, HI 96857 | 2007-05-18 |
1841408598 | Tripler Army Medical Center | Clinic/Center | Mccornack Rd Bldg 682, Schofield Barracks, HI 96857 | 2007-05-18 |
1275518805 | Spectrum Healthcare Resources | Clinic/Center | 98-340 Koauka Loop, Apt.124, Aiea, HI 96701-4443 | 2005-12-06 |
1992311930 | Branch Medical Clinic Naval Shipyard Pearl Harbor | Clinic/Center | 480 Central Ave, Pearl Harbor, HI 96860-4908 | 2020-09-16 |
1992953897 | Tripler Army Medical Center | Clinic/Center | 1 Jarrett White Rd, Na Koa Dental Clinic Bldg 678, Tripler Army Medical Center, HI 96859-5001 | 2008-09-04 |
1750548277 | Uscg Air Station Barbers Point | Clinic/Center | 1 Coral Sea St, Kapolei, HI 96707-3693 | 2008-05-21 |
1457550204 | Branch Medical Clinic Kaneohe | Clinic/Center | 480 Central Ave, Attn: Bhc Kaneohe Hawaii, Pearl Harbor, HI 96860-4908 | 2007-07-12 |
1073712824 | Branch Medical Clinic Camp Smith Medical Annex | Clinic/Center | 480 Central Ave, Code 02, Pearl Harbor, HI 96860-4908 | 2007-07-12 |
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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.