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WAILEA MEDICAL GROUP LLC
NPI 1497769988
Internal Medicine in Wailea, HI

Active since July 28, 2006
161 WAILEA IKE PL, #B102, WAILEA, HI 96753(808) 875-9095(808) 875-9098 Get Directions Write a Review

NPPES record last updated: September 16, 2015. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Wailea Medical Group Llc NPPES

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

WAILEA MEDICAL GROUP LLC (NPI 1497769988) is a healthcare organization registered as an internal medicine in Wailea, Hawaii and active in the NPI registry since July 2006. The organization lists Gregory L Park, M.d., as its authorized official.

NPPES Registry Identity

NPI1497769988
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameWAILEA MEDICAL GROUP LLC
Location Address161 WAILEA IKE PL, #B102Wailea, HI 96753-6521
Mailing Address161 Wailea Ike Pl, B-102Wailea, HI 96753-6521 · (808) 875-9095 · Fax (808) 875-9098
Phone(808) 875-9095
Fax(808) 875-9098
Organization SubpartNo
Authorized OfficialGregory L ParkM.d. · (808) 875-9095
Enumeration DateJuly 28, 2006
Last NPPES UpdateSeptember 16, 2015
✔ NPI 1497769988 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in HI · 3915
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
161 WAILEA IKE PL, Wailea, HI 96753
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Other Identifiers 3

Medicare PIN1497769988HI
Medicare UPIND36405HI
Medicaid045506-02HI

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Wailea Medical Group Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Wailea Medical Group LLC, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (2)

Gregory Park, M.D.
Internal Medicine
NPI 1861497596
30 N CHURCH ST
Wailuku, HI 96793
(808) 244-7627
✔ PECOS14 mi
Maria-Teresa David, D.O.
Internal Medicine
NPI 1013914787
100 WHETSTONE PL STE 105
St Augustine, FL 32086
(904) 824-3777
✔ PECOS4,664 mi

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

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 Wailea Medical Group LLC's NPI number?

The NPI number for Wailea Medical Group LLC is 1497769988. It was assigned to this organization in the NPPES registry on July 28, 2006.

Where is Wailea Medical Group LLC located?

Wailea Medical Group LLC is located at 161 Wailea Ike Pl #b102, Wailea, HI 96753. The listed phone number is (808) 875-9095.

What is Wailea Medical Group LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Wailea Medical Group LLC enrolled in Medicare?

Yes. Wailea Medical Group LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Wailea Medical Group LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Internal Medicine, reassign their Medicare billing to Wailea Medical Group LLC. 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.

When was this NPI record last updated?

The NPPES record for Wailea Medical Group LLC was last updated on September 16, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.