Individual provider Active NPI

Thomas A Glass, PH.D.

  • Psychologist
  • Honolulu, HI
National Provider Identifier
1154310530
Registry record updated Aug 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY037 Issued in HI
Practice address
1833 Kalakaua Ave
Suite 800
Honolulu, HI 96815-1528
Phone
(808) 955-7372
Fax
(808) 951-9282
NPI assigned
Oct 18, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY037 HI Primary

Addresses

Primary practice location

1833 Kalakaua Ave
Suite 800
Honolulu, HI 96815-1528

Mailing address

615 Piikoi St
Ste 1603
Honolulu, HI 96814
Phone (808) 596-8778

Other identifiers 2

IdentifierTypeStateIssuer
04997201MedicaidHI
56960OtherNMSA

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY037HIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological Services LLC Past 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": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312502400000",
    "number": "1154310530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 PIIKOI ST",
            "address_2": "STE 1603",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "96814",
            "telephone_number": "808-596-8778",
            "fax_number": "808-596-8558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1833 KALAKAUA AVE",
            "address_2": "SUITE 800",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968151528",
            "telephone_number": "808-955-7372",
            "fax_number": "808-951-9282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASS",
        "first_name": "THOMAS",
        "middle_name": "A",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2011-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "HI",
            "license": "PSY037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04997201",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NMSA",
            "identifier": "56960",
            "state": null
        }
    ],
    "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 Aug 5, 2011; 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.