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DR. THOMAS W EDHOLM M.D.
NPI 1285678953
Emergency Medicine - Emergency Medical Services in Kealakekua, HI

Active since June 15, 2006PECOS Enrolled
94.62/100
CMS Quality Rating
KONA COMMUNITY HOSPTIAL, 79-1019 HAUKAPILA STREET, KEALAKEKUA, HI 96750(808) 547-9593(808) 599-2714 Get Directions Write a Review

NPPES record last updated: July 18, 2016. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Dr. Thomas W Edholm M.d. NPPES

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

DR. THOMAS W EDHOLM M.D. (NPI 1285678953) is an individual emergency medical services provider in Kealakekua, Hawaii, licensed in Hawaii (MD 13810) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1285678953
Entity TypeIndividualMale
Primary Taxonomy207PE0004X
Provider Legal NameDR. THOMAS W EDHOLMCredential: M.D.
Location AddressKONA COMMUNITY HOSPTIAL, 79-1019 HAUKAPILA STREETKealakekua, HI 96750-7920
Mailing Address2100 Powell St, Ste 900Emeryville, CA 94608-1844 · (510) 851-7423 · Fax (510) 879-9120
Phone(808) 547-9593
Fax(808) 599-2714
Sole ProprietorNo
Enumeration DateJune 15, 2006
Last NPPES UpdateJuly 18, 2016
✔ NPI 1285678953 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyEmergency Medicine · Emergency Medical ServicesAllopathic & Osteopathic Physicians
Taxonomy Code207PE0004X
License✔ Licensed in HI · MD 13810
Definition
An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients.
Also ListedEmergency MedicineTaxonomy 207P00000X · License G80869 (CA)
KONA COMMUNITY HOSPTIAL, Kealakekua, HI 96750
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Other Identifiers 1

Medicare UPING45544

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Thomas W Edholm M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Thomas Edholm reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Cep America - California
2,361 mi
Emergency Medicine
600 MARINE BOULEVARD
Moss Beach, CA 94038
  • Reassigned Medicare billing, California enrollment
  • 2,323 clinicians in this Medicare group
NPI 1104871615 (650) 728-5521
Mayers Memorial Hospital District
2,512 mi
Critical Access
43563 HIGHWAY 299 EAST
Fall River Mills, CA 96028
  • Reassigned Medicare billing, California enrollment
  • 53 clinicians in this Medicare group
NPI 1912125667 (530) 336-5511

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
284 services260 patients
Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
196 services172 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
56 services53 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 96750 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$92.50 typical visit price
range $60.53 – $180.05
Typical copayment $23.12 (range $15.13 – $45.01)
Most-billed visit code 99203
Established Patient
$105.65 typical visit price
range $20.09 – $147.56
Typical copayment $26.41 (range $5.02 – $36.89)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

94.62/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality76.67
Improvement Activities40
Cost97.14

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 Thomas Edholm's NPI number?

The NPI number for Thomas Edholm is 1285678953. It was assigned to this individual provider in the NPPES registry on June 15, 2006.

Where is Thomas Edholm located?

Thomas Edholm practices at Kona Community Hosptial 79-1019 Haukapila Street, Kealakekua, HI 96750. The listed phone number is (808) 547-9593.

What is Thomas Edholm's specialty?

The primary specialty registered for this NPI is Emergency Medicine, specializing in Emergency Medical Services, with taxonomy code 207PE0004X.

Is Thomas Edholm enrolled in Medicare?

Yes. Thomas Edholm is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Thomas Edholm's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Thomas Edholm reassigns Medicare benefits to 2 organizations: Cep America - California (Moss Beach, CA) and Mayers Memorial Hospital District (Fall River Mills, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Thomas Edholm's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Thomas Edholm was last updated on July 18, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.