David Douglas Derauf, MD
Individual provider Active NPI Public Health & General Preventive Medicine Physician · Honolulu, HI
NPI 1245305523 · NPPES record last updated Aug 28, 2013
Key facts
- NPI
- 1245305523
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Public Health & General Preventive Medicine Physician 2083P0901X
- License
- MD-6760 (HI)
- Practice address
- 2239 N School St
Honolulu, HI 96819-2539 - Phone
- (808) 791-9400
- Fax
- (808) 848-0979
- NPI assigned
- Nov 21, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Owned or controlled facilities with NPI records 6
Medicare Care Compare profile
- Specialty
- Preventive Medicine
- Education
- University of Minnesota, Duluth School of Medicine, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Kokua Kalihi Valley Comprehensive Family Services
Practice addresses (Care Compare)
2239 N School St
Honolulu, HI 96819-2539
Phone (808) 791-9400
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in HI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 6
| Facility | Type | Role | Since |
|---|---|---|---|
| Kokua Kalihi Valley Comprehensive Family Services |
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 Services |
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 Services |
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 Services |
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 Services |
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 Services |
Federally qualified health center | Corporate Officer W-2 Managing Employee Operational/Managerial Control |
Jul 1, 2003 Jul 1, 2003 Jul 1, 2003 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140318001953 | HI | Practitioner - Preventive Medicine |
1254329469 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD-6760 | HI | MD | Public Health & General Preventive Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kokua Kalihi Valley Comprehensive Family Services | Current |
Accepting new patients | |
| Kokua Kalihi Valley Comprehensive Family Services | Current |
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health & General Preventive Medicine Physician | 2083P0901X | MD-6760 | HI | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000992101 | Medicaid | HI | |
| 0005707801 | Other | HI | ALOHACARE |
| 0000065706 | Other | HI | HMSA |
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All providers in Honolulu, HI · Public Health & General Preventive Medicine Physician in Hawaii
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 28, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.