Individual provider Active NPI

Nicole Kanani Masukawa Nakamura, PSY.D.

  • Psychologist
  • Honolulu, HI
National Provider Identifier
1235382219
Registry record updated Oct 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1507 Issued in AL
Practice address
3660 Waialae Ave Ste 208
Honolulu, HI 96816-3258
Phone
(808) 818-8867
Fax
(888) 965-5669
NPI assigned
Nov 4, 2008
Last updated
Oct 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1507 AL Primary

Addresses

Primary practice location

3660 Waialae Ave Ste 208
Honolulu, HI 96816-3258

Mailing address

3660 Waialae Ave Ste 208
Honolulu, HI 96816-3258
Phone (808) 818-8867

Other identifiers 1

IdentifierTypeStateIssuer
VAD000OtherUPIN

Other names 1

  • Ms. Nicole Kanani Masukawa Former name

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
I20160204001735 HI Practitioner - Clinical Psychologist 8325277304 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3660 Waialae Ave
Suite 208
Honolulu, HI 96816-3258
Phone (808) 818-8867

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1507ALMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Manakai O Malama Integrative CurrentSince Sep 1, 2021 Accepting new patients

Locations

677 Ala Moana Blvd
Spc 950
Honolulu, HI 96813
Phone (808) 535-5555

Networks

  • devoted network organization-c89d4c14-e90f-4cf7-83f9-456527a52335

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": "1225756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760659200000",
    "number": "1235382219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3660 WAIALAE AVE STE 208",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968163258",
            "telephone_number": "808-818-8867",
            "fax_number": "888-965-5669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3660 WAIALAE AVE STE 208",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968163258",
            "telephone_number": "808-818-8867",
            "fax_number": "888-965-5669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAKAMURA",
        "first_name": "NICOLE",
        "middle_name": "KANANI MASUKAWA",
        "name_prefix": "Mrs.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-04",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AL",
            "license": "1507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "VAD000",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "MASUKAWA",
            "middle_name": "KANANI",
            "prefix": "MS.",
            "credential": "PSY.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.