Individual provider Active NPI

Nicole Marie Robello Aurellano, PSY.D.

  • Clinical Psychologist
  • Waimanalo, HI
National Provider Identifier
1326440116
Registry record updated Jan 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 1489 Issued in HI
Practice address
41-1347 Kalanianaole Hwy
Waimanalo, HI 96795-1247
Phone
(808) 259-7948
NPI assigned
Sep 23, 2014
Last updated
Jan 24, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2017

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 1489 HI Primary

Addresses

Primary practice location

41-1347 Kalanianaole Hwy
Waimanalo, HI 96795-1247

Mailing address

92-1295 Hookeha St
Kapolei, HI 96707-1572
Phone (808) 348-1553

Other identifiers 1

IdentifierTypeStateIssuer
PSY- 1489OtherHILICENSE NUMBER

Other names 1

  • Ms. Nicole Marie Robello 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
I20141024000159 HI Practitioner - Clinical Psychologist 6507087103 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Care Physician Enterprise LLCGroup PAC ID 0244661338, 12 clinicians

Practice addresses (Care Compare)

677 Ala Moana Blvd
Honolulu, HI 96813-5415

91 -6390 Kapolei Pkwy
Suite 200
Ewa Beach, HI 96706-6380
Phone (808) 691-8200

98 -1079 Moanalua Rd
Aiea, HI 96701-4713
Phone (808) 486-6000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY 1489HIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
University Clinical Education & Research Associates CurrentSince Jun 15, 2019 Accepting new patients
Primary Care Physician Enterprise LLC CurrentSince Jun 30, 2020 Accepting new patients
University Clinical Education & Research Associates CurrentSince Jun 15, 2019 Accepting new patients
NA Pu'Uwai PastSince Sep 23, 2014 Accepting new patients
Nicole Aurellano, PSYD, LLC PastSince Mar 29, 2020 Accepting new patients

Locations

98-1079 Moanalua Rd
Aiea, HI 96701
Phone (808) 485-4301

91-6390 Kapolei Pkwy
Ste 200
Ewa Beach, HI 96706
Phone (612) 802-2986

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21516/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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": "1411430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485216000000",
    "number": "1326440116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92-1295 HOOKEHA ST",
            "city": "KAPOLEI",
            "state": "HI",
            "postal_code": "967071572",
            "telephone_number": "808-348-1553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41-1347 KALANIANAOLE HWY",
            "city": "WAIMANALO",
            "state": "HI",
            "postal_code": "967951247",
            "telephone_number": "808-259-7948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AURELLANO",
        "first_name": "NICOLE",
        "middle_name": "MARIE ROBELLO",
        "name_prefix": "Mrs.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-23",
        "last_updated": "2017-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "HI",
            "license": "PSY 1489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "PSY- 1489",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "ROBELLO",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "credential": "PSY.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Waimanalo, HI

Sources for this page

Verify at the official NPI Registry.