Individual provider Active NPI

Janna Marie Madeira, PSY.D.

  • Psychologist
  • Kapolei, HI
National Provider Identifier
1194039230
Registry record updated Mar 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY-1244 Issued in HI
Practice address
91-1010 Shangrila St Ste 105
Kapolei, HI 96707-2176
Phone
(808) 377-4300
NPI assigned
Jul 30, 2010
Last updated
Mar 13, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY-1244 HI Primary

Addresses

Primary practice location

91-1010 Shangrila St Ste 105
Kapolei, HI 96707-2176

Mailing address

PO Box 701089
Kapolei, HI 96709-1089
Phone (808) 377-4300

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
I20130624000690 HI Practitioner - Clinical Psychologist 6507005501 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crossroads Behavioral Health, IncGroup PAC ID 5092040048, 3 clinicians

Practice addresses (Care Compare)

91 -1010 Shangrila St
Suite 105
Kapolei, HI 96707-2176
Phone (808) 377-4300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY-1244HIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Crossroads Behavioral Health, Inc. CurrentSince May 7, 2019 Accepting new patients
Islands Hospice, Inc. PastSince Jun 1, 2013 Accepting new patients

Locations

91-1010 Shangrila St
Ste 105
Kapolei, HI 96707
Phone (808) 377-4300

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": "1280448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552435200000",
    "number": "1194039230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 701089",
            "city": "KAPOLEI",
            "state": "HI",
            "postal_code": "967091089",
            "telephone_number": "808-377-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91-1010 SHANGRILA ST STE 105",
            "city": "KAPOLEI",
            "state": "HI",
            "postal_code": "967072176",
            "telephone_number": "808-377-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADEIRA",
        "first_name": "JANNA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-30",
        "last_updated": "2019-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "HI",
            "license": "PSY-1244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kapolei, HI

Sources for this page

Verify at the official NPI Registry.