NPIMap

Individual provider Active NPI

Victoria Kay Hanes, PSY.D.

  • Clinical Psychologist
  • Kailua Kona, HI
National Provider Identifier
1164727079
Registry record updated Feb 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 1234 Issued in HI
Practice address
75-5751 Kuakini Hwy Ste 101a
Kailua Kona, HI 96740-1705
Phone
(808) 326-5629
Fax
(808) 329-5057
NPI assigned
Jan 24, 2011
Last updated
Feb 25, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2021

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 1234 HI Primary

Addresses

Primary practice location

75-5751 Kuakini Hwy Ste 101a
Kailua Kona, HI 96740-1705

Mailing address

75-5751 Kuakini Hwy Ste 203
Kailua Kona, HI 96740-1753
Phone (808) 326-5629

Other identifiers 1

IdentifierTypeStateIssuer
695108MedicaidHI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110225000293 HI Practitioner - Clinical Psychologist 7517148422 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

75-5751 Kuakini Hwy 203
Kailua Kona, HI 96740-1752

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY 1234HIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
West Hawaii Community Health Center, Inc. CurrentSince Feb 1, 2011 Accepting new patients
West Hawaii Community Health Center, Inc. CurrentSince Feb 1, 2011 Accepting new patients

Locations

75-5751 Kuakini Hwy
Ste 101A
Kailua Kona, HI 96740

75-5751 Kuakini Hwy
Ste 101A
Kailua Kona, HI 96740

75-5751 Kuakini Hwy
Ste 203
Kailua Kona, HI 96740
Phone (808) 326-3878

Networks

  • HI PPO

Interoperability endpoints

  • Direct secure messaging: victoria.reed@hawaiihie.medicity.net

Ownership & related parties

All facility ownership & control disclosures 19

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
West Hawaii Community Health Center IncKailua Kona, HI, CCN 121834 Federally qualified health center Corporate Officer
W-2 Managing Employee		 Mar 24, 2022
Aug 30, 2010
West Hawaii Community Health Center IncWaikoloa, HI, CCN 121848 Federally qualified health center Corporate Officer
W-2 Managing Employee		 May 26, 2020
Aug 30, 2010
West Hawaii Community Health Center IncKealakekua, HI, CCN 121852 Federally qualified health center Corporate Officer
W-2 Managing Employee		 May 26, 2020
Aug 30, 2010
West Hawaii Community Health Center IncKailua Kona, HI, CCN 121855 Federally qualified health center Corporate Officer
W-2 Managing Employee		 May 26, 2020
Aug 30, 2010
Hawai`I Island Community Health CenterKealakekua, HI, CCN 121879 Federally qualified health center Corporate Officer
W-2 Managing Employee		 May 26, 2020
May 26, 2020
Hawai`I Island Community Health CenterCaptain Cook, HI, CCN 121880 Federally qualified health center Corporate Officer
W-2 Managing Employee		 May 26, 2020
May 26, 2020
Whchc Kealakehe Intermediate SBHCKailua Kona, HI, CCN 121004 Federally qualified health center Corporate Officer
W-2 Managing Employee		 May 26, 2020
May 26, 2020
Whchc Kealakehe Elementary SBHCKailua Kona, HI, CCN 121008 Federally qualified health center Corporate Officer
W-2 Managing Employee		 May 26, 2020
May 26, 2020
Hawaii Island Community Health CenterNaalehu, HI, CCN 121811 Federally qualified health center W-2 Managing Employee May 26, 2020
Hawaii Island Community Health CenterHilo, HI, CCN 121804 Federally qualified health center W-2 Managing Employee May 26, 2020
Hawaii Island Community Health CenterPahoa, HI, CCN 121805 Federally qualified health center W-2 Managing Employee May 26, 2020
Hawaii Island Community Health CenterPahoa, HI, CCN 121839 Federally qualified health center W-2 Managing Employee May 26, 2020
Hawaii Island Community Health CenterPahoa, HI, CCN 121841 Federally qualified health center Corporate Officer
W-2 Managing Employee		 May 26, 2020
May 26, 2020
Hawaii Island Community Health CenterHilo, HI, CCN 121872 Federally qualified health center Corporate Officer
W-2 Managing Employee		 May 26, 2020
May 26, 2020
Hawaii Island Community Health CenterKeaau, HI, CCN 121829 Federally qualified health center Corporate Officer Aug 30, 2010
Hawaii Island Community Health CenterKealakekua, HI, CCN 121020 Federally qualified health center Corporate Officer
W-2 Managing Employee		 May 26, 2020
May 26, 2020
Hawaii Island Community Health CenterPapaikou, Hi, HI, CCN 121026 Federally qualified health center Corporate Officer
W-2 Managing Employee		 May 26, 2020
Aug 30, 2010
Hawaii Island Community Health CenterPahoa, HI, CCN 121029 Federally qualified health center Corporate Officer
W-2 Managing Employee		 May 26, 2020
Aug 30, 2010
Hawaii Island Community Health CenterKailua Kona, HI, CCN 121044 Federally qualified health center Corporate Officer
W-2 Managing Employee
Operational/Managerial Control		 May 26, 2020
Aug 30, 2010
May 26, 2020

Owned or controlled facilities with NPI records 19

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 19

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1295827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614211200000",
    "number": "1164727079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75-5751 KUAKINI HWY STE 203",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967401753",
            "telephone_number": "808-326-5629",
            "fax_number": "808-329-5057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75-5751 KUAKINI HWY STE 101A",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967401705",
            "telephone_number": "808-326-5629",
            "fax_number": "808-329-5057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANES",
        "first_name": "VICTORIA",
        "middle_name": "KAY",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-24",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "HI",
            "license": "PSY 1234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "695108",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kailua Kona, HI

Sources for this page

Verify at the official NPI Registry.