Individual provider Active NPI

Ayako Sakuragi, PSY.D.

  • Psychologist
  • Kailua Kona, HI
National Provider Identifier
1184932469
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY-1615 Issued in HI
Practice address
74-517 Honokohau St
Kailua Kona, HI 96740-2715
Phone
(808) 334-4472
NPI assigned
Sep 20, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY0610 NV
Psychologist 103T00000X PSY-1615 HI Primary

Addresses

Primary practice location

74-517 Honokohau St
Kailua Kona, HI 96740-2715

Mailing address

74-517 Honokohau St
Kailua Kona, HI 96740-2715
Phone (833) 833-3333

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
I20170216000789 HI Practitioner - Clinical Psychologist 8628298478 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY-1615HIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan Inc Current Accepting new patients
Kaiser Foundation Health Plan, Inc CurrentSince Jan 7, 2017 Accepting new patients
Kaiser Foundation Health Plan Inc CurrentSince Jan 7, 2017 Accepting new patients

Locations

711 Kapiolani Blvd
Honolulu, HI 96813
Phone (808) 432-5312

74-517 Honokohau St
Kailua Kona, HI 96740
Phone (808) 334-4400

599 Farrington Hwy
Kapolei, HI 96707
Phone (808) 432-3600

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": "1284940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1184932469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74-517 HONOKOHAU ST",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967402715",
            "telephone_number": "833-833-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74-517 HONOKOHAU ST",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967402715",
            "telephone_number": "808-334-4472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAKURAGI",
        "first_name": "AYAKO",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-20",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NV",
            "license": "PY0610",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "HI",
            "license": "PSY-1615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kailua Kona, HI

Sources for this page

Verify at the official NPI Registry.