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PUKALANI FAMILY PRACTICE, LLC
NPI 1063009207
Clinic/Center - Primary Care in Makawao, HI

Active since December 22, 2020CLIA 12D0724063 · Waiver
81 MAKAWAO AVE STE 100, MAKAWAO, HI 96768(808) 573-8900(808) 573-7505 Get Directions Write a Review

NPPES record last updated: December 22, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Pukalani Family Practice, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PUKALANI FAMILY PRACTICE, LLC (NPI 1063009207) is a healthcare organization registered as a primary care in Makawao, Hawaii and active in the NPI registry since December 2020. The organization holds a CLIA Waiver certificate valid through December 26, 2027 and lists Dayaji Green, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1063009207
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NamePUKALANI FAMILY PRACTICE, LLC
Location Address81 MAKAWAO AVE STE 100Makawao, HI 96768-8859
Mailing Address81 Makawao Ave Ste 100Makawao, HI 96768-8859 · (808) 573-8900 · Fax (808) 573-7505
Phone(808) 573-8900
Fax(808) 573-7505
Organization SubpartNo
Authorized OfficialDayaji GreenOffice Manager · (808) 573-8900
Enumeration DateDecember 22, 2020
NPPES CertifiedDecember 22, 2020
✔ NPI 1063009207 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X
Also ListedNurse Practitioner · GerontologyTaxonomy 363LG0600X
81 MAKAWAO AVE STE 100, Makawao, HI 96768
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HMSA.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 12D0724063

Pukalani Family Practice, LLC · Makawao, HI
Active · expires Dec 26, 2027
CLIA Number12D0724063
Laboratory TypePhysician Office
Certificate Effective DateDecember 27, 2025
Certificate Expiration DateDecember 26, 2027
Laboratory DirectorRobert Mastroianni
Laboratory Phone(808) 573-8900
Laboratory LocationPukalani Family Practice, LLC81 Makawao Ave, Ste 100, Makawao, HI 96768
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. DONNA A BANAL-BYRNES PA
Physician Assistant
81 MAKAWAO AVE STE 100
MAKAWAO, HI 96768
Maui County (808) 573-8900
SCOTT SADLER APRN
Nurse Practitioner (Family)
81 MAKAWAO AVE STE 100
MAKAWAO, HI 96768
Maui County (808) 573-8900
LIAT MILLER APRN
Nurse Practitioner (Family)
81 MAKAWAO AVE STE 100
MAKAWAO, HI 96768
Maui County (808) 573-8900
MS. CRISTINA ELIZABETH PROKOP A.P.R.N.
Nurse Practitioner (Adult Health)
81 MAKAWAO AVE STE 100
MAKAWAO, HI 96768
Maui County (808) 573-8900
MS. STACEY GREGORY APRN
Nurse Practitioner
81 MAKAWAO AVE STE 100
MAKAWAO, HI 96768
Maui County (808) 573-8900
MADISON C FURLONG APRN
Nurse Practitioner (Family)
81 MAKAWAO AVE STE 100
MAKAWAO, HI 96768
Maui County (808) 573-8900

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pukalani Family Practice, LLC's NPI number?

The NPI number for Pukalani Family Practice, LLC is 1063009207. It was assigned to this organization in the NPPES registry on December 22, 2020.

Where is Pukalani Family Practice, LLC located?

Pukalani Family Practice, LLC is located at 81 Makawao Ave Ste 100, Makawao, HI 96768. The listed phone number is (808) 573-8900.

What is Pukalani Family Practice, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does Pukalani Family Practice, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 12D0724063) is associated with this NPI, valid through December 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Pukalani Family Practice, LLC accept?

Health plans from HMSA list Pukalani Family Practice, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Pukalani Family Practice, LLC was last updated on December 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.