Individual provider Active NPI

Andrea Mieko Chun

  • Clinical Social Worker
  • Honolulu, HI
National Provider Identifier
1962512954
Registry record updated Sep 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3482 Issued in HI
Practice address
2228 Liliha St Ste 404
Honolulu, HI 96817-1654
Phone
(808) 462-2968
Fax
(808) 442-1419
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2021

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 3482 HI Primary

Addresses

Primary practice location

2228 Liliha St Ste 404
Honolulu, HI 96817-1654

Mailing address

PO Box 11644
Honolulu, HI 96828-0644
Phone (808) 462-2968

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
I20110415000069 HI Practitioner - Clinical Social Worker 3678757606 Reassigns benefits to 2 organizations
Practice locations: Honolulu, HI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2228 Liliha St
Suite 404
Honolulu, HI 96817-1654
Phone (808) 462-2968

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3482HIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Honolulu Psychiatric Services LLC CurrentSince Apr 1, 2018 Accepting new patients
The Queens Medical Center CurrentSince Jan 2, 2011 Accepting new patients
The Queens Medical Center CurrentSince Jan 2, 2011 Accepting new patients
The Queen'S Medical Center Current Accepting new patients

Locations

550 S Beretania St
Ste 404
Honolulu, HI 96813
Phone (808) 691-8897

2228 Liliha St
Ste 404
Honolulu, HI 96817
Phone (808) 258-0462

1301 Punchbowl St
Honolulu, HI 96813
Phone (808) 538-9011

Organizations & group practices 4

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631836800000",
    "number": "1962512954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11644",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968280644",
            "telephone_number": "808-462-2968",
            "fax_number": "808-442-1419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2228 LILIHA ST STE 404",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968171654",
            "telephone_number": "808-462-2968",
            "fax_number": "808-442-1419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUN",
        "first_name": "ANDREA",
        "middle_name": "MIEKO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "HI",
            "license": "3482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.