Organization Active NPI

Hawaii Cancer Care Inc

  • Specialist
  • Honolulu, HI
National Provider Identifier
1033565981
Registry record updated Oct 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
3621 Issued in HI
Legal business name
HAWAII CANCER CARE INC
Practice address
500 Ala Moana Blvd Ste 6230
Honolulu, HI 96813-4929
Phone
(808) 524-6115
Fax
(808) 528-1711
NPI assigned
May 10, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jon Fukumoto, MDNPI 1477663284
Title
President
Phone
(808) 524-6115

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 3621 HI Primary

Addresses

Primary practice location

500 Ala Moana Blvd Ste 6230
Honolulu, HI 96813-4929

Mailing address

500 Ala Moana Blvd Ste 6230
Honolulu, HI 96813-4929
Phone (808) 524-6115

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161121000879 HI Part B Supplier - Clinic/Group Practice 4183903842 Receives reassigned benefits from 6 practitioners
Practice locations: Aiea, HI; Honolulu, HI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
12D0662980Aop of Hawaii, PA Dba Hawaii Cancer Care Honolulu500 Ala Moana Blvd, Suite 6-230, Honolulu, HI 96813AccreditationMay 26, 2027

National Provider Directory

National Provider Directory

Locations

98-1247 Kaahumanu St
Ste 315
Aiea, HI 96701
Phone 8085246115519

98-150 Kaonohi St
Ste B219
Aiea, HI 96701

2226 Liliha St
Bsmt 204
Honolulu, HI 96817
Phone (808) 524-6115

1329 Lusitana St
Ste 307
Honolulu, HI 96813
Phone (808) 524-6115

642 Ulukahiki St
Ste 104
Kailua, HI 96734
Phone (808) 263-3233

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1462838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633392000000",
    "number": "1033565981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 ALA MOANA BLVD STE 6230",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968134929",
            "telephone_number": "808-524-6115",
            "fax_number": "808-528-1711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 ALA MOANA BLVD STE 6230",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968134929",
            "telephone_number": "808-524-6115",
            "fax_number": "808-528-1711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAWAII CANCER CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-10",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A",
        "authorized_official_last_name": "FUKUMOTO",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "808-524-6115",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "HI",
            "license": "3621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.