Individual provider Active NPI

Hannah Kalama Preston-Pita, PSY.D.

  • Clinical Psychologist
  • Keaau, HI
National Provider Identifier
1124358742
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 1165 Issued in HI
Practice address
16-179 Melekahiwa St
Keaau, HI 96749-8026
Phone
(808) 969-9994
Fax
(808) 961-5011
NPI assigned
Jan 4, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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 1165 HI Primary

Addresses

Primary practice location

16-179 Melekahiwa St
Keaau, HI 96749-8026

Mailing address

16-179 Melekahiwa St
Keaau, HI 96749-8026
Phone (808) 969-9994

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
I20100318000994 HI Practitioner - Clinical Psychologist 9638204373 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

16 -179 Melekahiwa St
Keaau, HI 96749-8026
Phone (808) 969-9994

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY 1165HIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Hawaii Island and Wellness Center Past Accepting new patients
Big Island Substance Abuse Council PastSince Apr 18, 2020 Accepting new patients

Organizations & group practices 3

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": "1262563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1124358742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16-179 MELEKAHIWA ST",
            "city": "KEAAU",
            "state": "HI",
            "postal_code": "967498026",
            "telephone_number": "808-969-9994",
            "fax_number": "808-961-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16-179 MELEKAHIWA ST",
            "city": "KEAAU",
            "state": "HI",
            "postal_code": "967498026",
            "telephone_number": "808-969-9994",
            "fax_number": "808-961-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESTON-PITA",
        "first_name": "HANNAH",
        "middle_name": "KALAMA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-04",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "HI",
            "license": "PSY 1165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keaau, HI

Sources for this page

Verify at the official NPI Registry.