NPIMap

Organization Active NPI

Kokua Kalihi Valley Comprehensive Family Services

  • Federally Qualified Health Center (FQHC)
  • Honolulu, HI
National Provider Identifier
1548733397
Registry record updated Jan 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
KOKUA KALIHI VALLEY COMPREHENSIVE FAMILY SERVICES
Practice address
3659 Kalihi St
Honolulu, HI 96819-3038
Phone
(808) 791-9400
Fax
(808) 848-0979
NPI assigned
Jan 4, 2019
Last updated
Jan 4, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2019

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

Authorized official

Name
Dr. David Derauf, MDNPI 1245305523
Title
Executive Director
Phone
(808) 791-9400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

3659 Kalihi St
Honolulu, HI 96819-3038

Mailing address

2239 N School St
Honolulu, HI 96819-2539
Phone (808) 791-9413

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190401001159 HI Part B Supplier - Clinic/Group Practice 0547258741 Receives reassigned benefits from 39 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Honolulu, HI

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1546560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546560000000",
    "number": "1548733397",
    "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": "808-791-9413",
            "fax_number": "808-848-0979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3659 KALIHI ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968193038",
            "telephone_number": "808-791-9400",
            "fax_number": "808-848-0979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOKUA KALIHI VALLEY COMPREHENSIVE FAMILY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-04",
        "last_updated": "2019-01-04",
        "status": "A",
        "authorized_official_last_name": "DERAUF",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "808-791-9400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "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 Jan 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.