Individual provider Active NPI

Naomi Takemoto-Chock, PH.D.

  • Psychologist
  • Hilo, HI
National Provider Identifier
1013918291
Registry record updated Sep 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
333 Issued in HI
Practice address
1978 Komohana St
Hilo, HI 96720-5941
Phone
(808) 959-4948
NPI assigned
Aug 10, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 333 HI Primary

Addresses

Primary practice location

1978 Komohana St
Hilo, HI 96720-5941

Mailing address

1978 Komohana St
Hilo, HI 96720-5941
Phone (808) 959-4948

Other identifiers 1

IdentifierTypeStateIssuer
02373701MedicaidHI

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
I20060106000471 HI Practitioner - Clinical Psychologist 3779506530 Practice locations: Hilo, HI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1978 Komohana St
Hilo, HI 96720-5935
Phone (808) 959-4948

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
333HIMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221177600000",
    "number": "1013918291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1978 KOMOHANA ST",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967205941",
            "telephone_number": "808-959-4948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1978 KOMOHANA ST",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967205941",
            "telephone_number": "808-959-4948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAKEMOTO-CHOCK",
        "first_name": "NAOMI",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-10",
        "last_updated": "2008-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "HI",
            "license": "333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02373701",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilo, HI

Sources for this page

Verify at the official NPI Registry.