Individual provider Active NPI

Robyn Mahana Sandefur, PSY D

  • Clinical Psychologist
  • Honolulu, HI
National Provider Identifier
1235421926
Registry record updated Jun 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY-1255 Issued in HI
Practice address
401 Kamakee Street
Suite 409
Honolulu, HI 96814
Phone
(808) 729-7698
Fax
(866) 313-3630
NPI assigned
May 12, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2018

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-1255 HI Primary

Addresses

Primary practice location

401 Kamakee Street
Suite 409
Honolulu, HI 96814

Mailing address

401 Kamake'E Street
Suite 409
Honolulu, HI 96814
Phone (808) 729-7698

Other names 1

  • Ms. Robyn Mahana Chang 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
I20110811000200 HI Practitioner - Clinical Psychologist 3274702105 Reassigns benefits to 1 organization
Practice locations: Honolulu, HI

Care Compare profile

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

Practice addresses (Care Compare)

401 Kamakee St
Suite 409
Honolulu, HI 96814-4261
Phone (808) 729-7698

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY-1255HIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
I Ola Lahui Inc Clinical CurrentSince Jan 23, 2017 Accepting new patients

Locations

1441 Kapiolani Blvd
Ste 1802
Honolulu, HI 96814
Phone (808) 525-6234

Networks

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

Organizations & group practices 1

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": "1305158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1235421926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 KAMAKE'E STREET",
            "address_2": "SUITE 409",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "96814",
            "telephone_number": "808-729-7698",
            "fax_number": "866-313-3630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 KAMAKEE STREET",
            "address_2": "SUITE 409",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "96814",
            "telephone_number": "808-729-7698",
            "fax_number": "866-313-3630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDEFUR",
        "first_name": "ROBYN",
        "middle_name": "MAHANA",
        "name_prefix": "Mrs.",
        "credential": "PSY D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-12",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "HI",
            "license": "PSY-1255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROBYN",
            "last_name": "CHANG",
            "middle_name": "MAHANA",
            "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.