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WAHIAWA FAMILY PRACTICE CLINIC INC
NPI 1386753903
Clinic/Center in Wahiawa, HI

Active since August 29, 2006CLIA 12D0992012 · Microscopy
302 CALIFORNIA AVE, SUITE 103, WAHIAWA, HI 96786(808) 621-7733(808) 621-7799 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Wahiawa Family Practice Clinic Inc NPPES

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

WAHIAWA FAMILY PRACTICE CLINIC INC (NPI 1386753903) is a healthcare organization registered as a clinic/center in Wahiawa, Hawaii and active in the NPI registry since August 2006. The organization holds a CLIA Microscopy certificate valid through October 3, 2027 and lists Jason Tai Pang Lam, President, as its authorized official.

NPPES Registry Identity

NPI1386753903
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameWAHIAWA FAMILY PRACTICE CLINIC INC
Location Address302 CALIFORNIA AVE, SUITE 103Wahiawa, HI 96786-1841
Mailing Address302 California Ave, Suite 103Wahiawa, HI 96786-1841 · (808) 621-7733 · Fax (808) 621-7799
Phone(808) 621-7733
Fax(808) 621-7799
Organization SubpartNo
Authorized OfficialJason Tai Pang LamPresident · (808) 621-7733
Enumeration DateAugust 29, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1386753903 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
License✔ Licensed in HI · MD11212
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
302 CALIFORNIA AVE, Wahiawa, HI 96786
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Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Wahiawa Family Practice Clinic Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Wahiawa Family Practice Clinic Inc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Jason Lam, MD
Family Practice
NPI 1114033040
302 CALIFORNIA AVE SUITE 103
Wahiawa, HI 96786
(808) 621-7733
✔ PECOS✔ Accepts MedicareSame address

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

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 for Provider-Performed Microscopy Procedures (PPMP) 12D0992012

Wahiawa Family Practice Clinic Jason T Lam, MD · Wahiawa, HI
Active · expires Oct 3, 2027
CLIA Number12D0992012
Laboratory TypePhysician Office
Certificate Effective DateOctober 4, 2025
Certificate Expiration DateOctober 3, 2027
Laboratory DirectorJason T. Lam, MD
Laboratory Phone(808) 621-7733
Laboratory LocationWahiawa Family Practice Clinic Jason T Lam, MD302 California Ave #103, Wahiawa, HI 96786
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

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 Wahiawa Family Practice Clinic Inc's NPI number?

The NPI number for Wahiawa Family Practice Clinic Inc is 1386753903. It was assigned to this organization in the NPPES registry on August 29, 2006.

Where is Wahiawa Family Practice Clinic Inc located?

Wahiawa Family Practice Clinic Inc is located at 302 California Ave Suite 103, Wahiawa, HI 96786. The listed phone number is (808) 621-7733.

What is Wahiawa Family Practice Clinic Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Is Wahiawa Family Practice Clinic Inc enrolled in Medicare?

Yes. Wahiawa Family Practice Clinic Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Wahiawa Family Practice Clinic Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Wahiawa Family Practice Clinic Inc. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Wahiawa Family Practice Clinic Inc hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 12D0992012) is associated with this NPI, valid through October 3, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Wahiawa Family Practice Clinic Inc was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.