Individual provider Active NPI

Derek Matthew Flores, M.D.

  • Pediatrics Physician
  • Honolulu, HI
National Provider Identifier
1992829816
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
14130 Issued in HI
Practice address
1319 Punahou St
Honolulu, HI 96826-1001
Phone
(808) 983-8387
NPI assigned
Mar 17, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 14130 HI Primary

Addresses

Primary practice location

1319 Punahou St
Honolulu, HI 96826-1001

Mailing address

94-201 Pouhana Loop
Waipahu, HI 96797-5827
Phone (808) 688-1910

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071010000567 HI Practitioner - Pediatric Medicine 0941396626 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14130HIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Straub Clinic & Hospital CurrentSince Nov 2, 2010 Accepting new patients
Straub Clinic & Hospital CurrentSince Nov 2, 2010 Accepting new patients
Kapiolani Medical Center for Women & Children Past Accepting new patients
Straub Clinic & Hospital Past Accepting new patients

Locations

98-151 Pali Momi St
Ste 142
Aiea, HI 96701
Phone (808) 483-6400

888 S King St
Honolulu, HI 96813
Phone (808) 522-4000

1319 Punahou St
Honolulu, HI 96826
Phone (808) 485-4300

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": "1174089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992829816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94-201 POUHANA LOOP",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967975827",
            "telephone_number": "808-688-1910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1319 PUNAHOU ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968261001",
            "telephone_number": "808-983-8387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLORES",
        "first_name": "DEREK",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "HI",
            "license": "14130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.