Individual provider Active NPI

Nancy M. Sidun, PSYD

  • Clinical Psychologist
  • Honolulu, HI
National Provider Identifier
1043392988
Registry record updated Oct 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY-796 Issued in HI
Practice address
1441 Kapiolani Blvd FL 16
Honolulu, HI 96814-4402
Phone
(808) 432-7600
NPI assigned
Oct 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY-796 HI Primary

Addresses

Primary practice location

1441 Kapiolani Blvd FL 16
Honolulu, HI 96814-4402

Mailing address

1441 Kapiolani Blvd FL 16
Honolulu, HI 96814-4402
Phone (808) 432-7600

Other identifiers 1

IdentifierTypeStateIssuer
56528601MedicaidHI

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
I20050314000240 HI Practitioner - Clinical Psychologist 7315992351 Practice locations: Honolulu, HI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1195 Kamehame Dr
Honolulu, HI 96825-3504
Phone (808) 778-0204

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hawaii Permanente Medical Group Inc PastSince Jul 11, 2016 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": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191888000000",
    "number": "1043392988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 KAPIOLANI BLVD FL 16",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968144402",
            "telephone_number": "808-432-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 KAPIOLANI BLVD FL 16",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968144402",
            "telephone_number": "808-432-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDUN",
        "first_name": "NANCY",
        "middle_name": "M.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2007-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "HI",
            "license": "PSY-796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "56528601",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.