| Lanai Community Health Center | |
|
333 Sixth St Lanai City HI 96763 | |
| (808) 565-6919 | |
| Not Available |
| Full Name | Lanai Community Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 333 Sixth St, Lanai City, Hawaii |
| Authorized Official Name and Position | Jacey G Laborte (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 8086495407 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lanai Community Health Center Po Box 630142 Po Box 630142 Lanai City HI 96763-0142 Ph: (808) 565-6919 | Lanai Community Health Center 333 Sixth St Lanai City HI 96763 Ph: (808) 565-6919 |
| NPI Number | 1679754097 |
|---|---|
| Provider Enumeration Date | 11/15/2007 |
| Last Update Date | 05/08/2026 |
| Certification Date | 05/08/2026 |
| Medicare PECOS PAC ID | 5395828925 |
|---|---|
| Medicare Enrollment ID | O20120629000093 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679754097 | NPI | - | NPPES |
| 509596 | Medicaid | HI | |
| 121854 | Medicaid | HI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | () | Primary |
| Provider Name | Anthony Guerrero |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770536070 PECOS PAC ID: 0547250680 Enrollment ID: I20040512001256 |
| Provider Name | Allison Dsh Seales |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1790014363 PECOS PAC ID: 2567505712 Enrollment ID: I20100210000255 |
| Provider Name | Joseph Humphry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033270327 PECOS PAC ID: 9436337532 Enrollment ID: I20110620000332 |
| Provider Name | Jared Hironobu Nuuhiwa Medeiros |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043617103 PECOS PAC ID: 2466773361 Enrollment ID: I20150603002947 |
| Provider Name | Anil Haresh Punjabi |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1821387853 PECOS PAC ID: 4981820040 Enrollment ID: I20181217002946 |
| Provider Name | Kris Aceret |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720548027 PECOS PAC ID: 7517299035 Enrollment ID: I20191031003205 |
| Provider Name | Taryn Achong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164006656 PECOS PAC ID: 1052717261 Enrollment ID: I20210913002352 |
| Provider Name | Cori Takesue |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1942409156 PECOS PAC ID: 4688071582 Enrollment ID: I20210920002518 |
| Provider Name | Olivia Agtarap Pascual |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841058401 PECOS PAC ID: 4587002431 Enrollment ID: I20240410003678 |
| Provider Name | Vanessa Viloria |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1912382961 PECOS PAC ID: 7517272792 Enrollment ID: I20240515002173 |
| Provider Name | Joseph Ahlborn |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1124366687 PECOS PAC ID: 6204209463 Enrollment ID: I20240815001075 |
| Provider Name | Marques Bostic |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1265753404 PECOS PAC ID: 3779768742 Enrollment ID: I20260107001709 |
Lanai Community Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 333 Sixth Street, Lanai City, HI 96763 Phone: 808-565-6919 Fax: 808-565-9111 |