Individual provider Active NPI

Michael Makoto Kalaeula Bopa Lee

  • Cognitive & Behavioral Psychologist
  • Honolulu, HI
National Provider Identifier
1013487479
Registry record updated Nov 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X
Practice address
875 Waimanu St Ste 612
Honolulu, HI 96813-5267
Phone
(808) 791-6713
Fax
(808) 791-6081
NPI assigned
Nov 28, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X Primary

Addresses

Primary practice location

875 Waimanu St Ste 612
Honolulu, HI 96813-5267

Mailing address

875 Waimanu St Ste 612
Honolulu, HI 96813-5267
Phone (808) 791-6713

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1543363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543363200000",
    "number": "1013487479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 WAIMANU ST STE 612",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968135267",
            "telephone_number": "808-791-6713",
            "fax_number": "808-791-6081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 WAIMANU ST STE 612",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968135267",
            "telephone_number": "808-791-6713",
            "fax_number": "808-791-6081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "MICHAEL",
        "middle_name": "MAKOTO KALAEULA BOPA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-28",
        "last_updated": "2018-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "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 Nov 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.