Organization Active NPI

David Fitz-Patrick, MD Inc.

  • Specialist
  • Honolulu, HI
National Provider Identifier
1932250479
Registry record updated Jun 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD4149 Issued in HI
Legal business name
DAVID FITZ-PATRICK, MD INC.
Practice address
1585 Kapiolani Blvd
Suite 1500
Honolulu, HI 96814-4522
Phone
(808) 531-6886
Fax
(808) 523-5115
NPI assigned
Jan 12, 2007
Last updated
Jun 30, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2010

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

Authorized official

Name
Betty J Fitz-Patrick
Title
Office Manager
Phone
(808) 440-4413

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD4149 HI Primary

Addresses

Primary practice location

1585 Kapiolani Blvd
Suite 1500
Honolulu, HI 96814-4522

Mailing address

1585 Kapiolani Blvd
Suite 1500
Honolulu, HI 96814-4522
Phone (808) 531-6886

Other identifiers 1

IdentifierTypeStateIssuer
04789303MedicaidHI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040224001318 HI Part B Supplier - Clinic/Group Practice 2062308224 Receives reassigned benefits from 6 practitioners
Practice locations: 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
12D0674128David Fitz Patrick MD1585 Kapiolani Blvd, Suite 1500, Honolulu, HI 96814Certificate of waiverApr 11, 2028

National Provider Directory

National Provider Directory

Locations

1585 Kapiolani Blvd
Ste 1500
Honolulu, HI 96814
Phone (808) 440-4413

Practitioners & affiliated clinicians

Practitioners 8

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": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277856000000",
    "number": "1932250479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1585 KAPIOLANI BLVD",
            "address_2": "SUITE 1500",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968144522",
            "telephone_number": "808-531-6886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1585 KAPIOLANI BLVD",
            "address_2": "SUITE 1500",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968144522",
            "telephone_number": "808-531-6886",
            "fax_number": "808-523-5115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID FITZ-PATRICK, MD INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-12",
        "last_updated": "2010-06-30",
        "status": "A",
        "authorized_official_last_name": "FITZ-PATRICK",
        "authorized_official_first_name": "BETTY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "808-440-4413"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "HI",
            "license": "MD4149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04789303",
            "state": "HI"
        }
    ],
    "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 Jun 30, 2010; 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.