Individual provider Active NPI

David Fundakowski

  • Clinical Social Worker
  • Honolulu, HI
National Provider Identifier
1154844454
Registry record updated Feb 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-4129 Issued in HI
Practice address
1001 Bishop St Ste 2685a
Honolulu, HI 96813-3404
Phone
(808) 443-9803
NPI assigned
Jul 19, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW-4129 HI Primary

Addresses

Primary practice location

1001 Bishop St Ste 2685a
Honolulu, HI 96813-3404

Mailing address

433A Kukuau St
Hilo, HI 96720-7806
Phone (808) 443-9803

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250326003708 HI Practitioner - Clinical Social Worker 3173046521 Reassigns benefits to 1 organization
Practice locations: Honolulu, HI

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy With Aloha LLC Clinical CurrentSince Mar 1, 2025 Accepting new patients
Mental Health Specialty Group PA CurrentSince May 1, 2025 Accepting new patients

Locations

1001 Bishop St
Ste 2685A
Honolulu, HI 96813
Phone (706) 715-3105

500 Ala Moana Blvd
Ste 7400
Honolulu, HI 96813
Phone (617) 823-6490

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1500422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739577600000",
    "number": "1154844454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433A KUKUAU ST",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967207806",
            "telephone_number": "808-443-9803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 BISHOP ST STE 2685A",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968133404",
            "telephone_number": "808-443-9803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNDAKOWSKI",
        "first_name": "DAVID",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-19",
        "last_updated": "2025-02-15",
        "certification_date": "2025-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "HI",
            "license": "LCSW-4129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.