Edward James Wilfong, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY-1809 Issued in HI

Practice address

331A Pukalani St
Makawao, HI 96768-8433

Phone

(808) 666-9766

NPI assigned

Jun 9, 2016

Last updated

Mar 5, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Clinical Psychologist

Education

Other, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Seatac Senior Psychology LLCGroup PAC ID 7719032226, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: edwardwilfong@tdh.allscriptsdirect.net

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.

• Seatac Senior Psychology LLC

  dba Senior Connections

  • Clinical Psychologist
  • Vancouver, WA
  • NPI 1831326834
  Medicare reassignment Care Compare group NPD
• Seatac Senior Psychology LLC

  dba Senior Connections

  • Clinical Psychologist
  • Vancouver, WA
  • NPI 1639306582
  NPD
• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Single Specialty

  NPD

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

{
    "created_epoch": "1465430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614902400000",
    "number": "1215386248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331A PUKALANI ST",
            "city": "MAKAWAO",
            "state": "HI",
            "postal_code": "967688433",
            "telephone_number": "808-666-9766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331A PUKALANI ST",
            "city": "MAKAWAO",
            "state": "HI",
            "postal_code": "967688433",
            "telephone_number": "808-666-9766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILFONG",
        "first_name": "EDWARD",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-09",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "HI",
            "license": "PSY-1809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://edwilfong.clientsecure.me",
            "affiliation": "N",
            "endpointDescription": "HIPPA compliant client portal",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "HIPPA secure EMR and Scheduling portal",
            "address_1": "331A Pukalani St",
            "city": "Makawao",
            "state": "HI",
            "country_code": "US",
            "postal_code": "967688433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dana Ventura, M.S., CCC-SLP
• Michelle Villanti, LCSW
• Nathan James Waara, DC
• Richard Joseph Walker II, D.C.
• Andrea Werbalowsky, LMHC
• Kara Williams, M.T.
• Sarah Monique Williams, PSY D
• Kathryn Wilmet, LMHC
• James Ward Woessner, MD, PHD
• Joyce Wright

• Clinical Psychologist in Makawao, HI
• Providers in Makawao, HI by specialty
• Clinical Psychologist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.