Individual provider Active NPI

Jadu Malcolm Jagel, PSYD

  • Clinical Psychologist
  • Kaneohe, HI
National Provider Identifier
1003979477
Registry record updated Jun 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY-2088-0 Issued in HI
Practice address
47-506 Hio PL
Kaneohe, HI 96744-4840
Phone
(415) 846-2511
NPI assigned
Dec 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Psychologist 103TF0000X
Clinical Psychologist 103TC0700X PSY-2088-0 HI Primary

Addresses

Primary practice location

47-506 Hio PL
Kaneohe, HI 96744-4840

Mailing address

47-506 Hio PL
Kaneohe, HI 96744-4840
Phone (415) 846-2511

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
I20250523000311 HI Practitioner - Clinical Psychologist 0244759132 Practice locations: Kailua, HI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

142 Maluniu Ave
Apt B
Kailua, HI 96734-5809

970 N Kalaheo Ave
Suite C201
Kailua, HI 96734-1872
Phone (415) 846-2511

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY-2088-0HIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Jadu Malcolm Jagel, PSYD Clinical CurrentSince Mar 3, 2024 Accepting new patients

Organizations & group practices 1

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": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686873600000",
    "number": "1003979477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47-506 HIO PL",
            "city": "KANEOHE",
            "state": "HI",
            "postal_code": "967444840",
            "telephone_number": "415-846-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47-506 HIO PL",
            "city": "KANEOHE",
            "state": "HI",
            "postal_code": "967444840",
            "telephone_number": "415-846-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAGEL",
        "first_name": "JADU",
        "middle_name": "MALCOLM",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "HI",
            "license": "PSY-2088-0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kaneohe, HI

Sources for this page

Verify at the official NPI Registry.