NPIMap

Individual provider Active NPI

David Douglas Derauf, MD

  • Public Health & General Preventive Medicine Physician
  • Honolulu, HI
National Provider Identifier
1245305523
Registry record updated Aug 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X
License
MD-6760 Issued in HI
Practice address
2239 N School St
Honolulu, HI 96819-2539
Phone
(808) 791-9400
Fax
(808) 848-0979
NPI assigned
Nov 21, 2006
Last updated
Aug 28, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health & General Preventive Medicine Physician 2083P0901X MD-6760 HI Primary

Addresses

Primary practice location

2239 N School St
Honolulu, HI 96819-2539

Mailing address

2239 N School St
Honolulu, HI 96819-2539
Phone (808) 791-9400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140318001953 HI Practitioner - Preventive MedicinePractitioner - General Practice 1254329469 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Preventive MedicineAlso: General Practice
Education
University of Minnesota, Duluth School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2239 N School St
Honolulu, HI 96819-2539
Phone (808) 791-9400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Kokua Kalihi Valley Comprehensive Family Services CurrentSince Jul 29, 2013 Accepting new patients
Kokua Kalihi Valley Comprehensive Family Services CurrentSince Jul 1, 2003 Accepting new patients
Kokua Kalihi Valley Comprehensive Family Services Past Accepting new patients

Locations

2239 N School St
Honolulu, HI 96819
Phone (808) 791-9400

Ownership & related parties

All facility ownership & control disclosures 6

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Kokua Kalihi Valley Comprehensive Family ServicesHonolulu, HI, CCN 121837 Federally qualified health center Corporate Officer
W-2 Managing Employee
Operational/Managerial Control		 Jul 1, 2003
Jul 1, 2003
Jul 1, 2003
Kokua Kalihi Valley Comprehensive Family ServicesHonolulu, HI, CCN 121838 Federally qualified health center Corporate Officer
W-2 Managing Employee
Operational/Managerial Control		 Jul 1, 2003
Jul 1, 2003
Jul 1, 2003
Kokua Kalihi Valley Comprehensive Family ServicesHonolulu, HI, CCN 121800 Federally qualified health center Corporate Officer
W-2 Managing Employee
Operational/Managerial Control		 Jul 1, 2003
Jul 1, 2003
Jul 1, 2003
Kokua Kalihi Valley Comprehensive Family ServicesHonolulu, HI, CCN 121847 Federally qualified health center Corporate Officer
W-2 Managing Employee
Operational/Managerial Control		 Jul 1, 2003
Jul 1, 2003
Jul 1, 2003
Kokua Kalihi Valley Comprehensive Family ServicesHonolulu, HI, CCN 121851 Federally qualified health center Corporate Officer
W-2 Managing Employee
Operational/Managerial Control		 Jul 1, 2003
Jul 1, 2003
Jul 1, 2003
Kokua Kalihi Valley Comprehensive Family ServicesHonolulu, HI, CCN 121871 Federally qualified health center Corporate Officer
W-2 Managing Employee
Operational/Managerial Control		 Jul 1, 2003
Jul 1, 2003
Jul 1, 2003

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 8

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

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377648000000",
    "number": "1245305523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2239 N SCHOOL ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968192539",
            "telephone_number": "808-791-9400",
            "fax_number": "808-848-0979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2239 N SCHOOL ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968192539",
            "telephone_number": "808-791-9400",
            "fax_number": "808-848-0979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERAUF",
        "first_name": "DAVID",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2013-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "HI",
            "license": "MD-6760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.