Individual provider Active NPI

Chad Thomas Taylor, PSY.D.

  • Psychologist
  • Waianae, HI
National Provider Identifier
1336207760
Registry record updated Nov 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
86-260 Farrington Hwy
Waianae, HI 96792-3128
Phone
(808) 696-7081
Fax
(808) 696-7093
NPI assigned
Dec 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X Primary
Psychologist 103T00000X PSY1016 HI

Addresses

Primary practice location

86-260 Farrington Hwy
Waianae, HI 96792-3128

Mailing address

86-260 Farrington Hwy
Waianae, HI 96792-3128
Phone (808) 696-7081

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
I20071023000119 HI Practitioner - Clinical Psychologist 3072609064 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

86-260 Farringtion Hwy
Waianae, HI 96792-3128
Phone (808) 697-3300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY1016HIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Waianae District Comprehensive Health and Hospital Board, Inc CurrentSince Apr 30, 2014 Accepting new patients
Waianae District Comprehensive Health and Hospital Board, Inc Current Accepting new patients
Waianae District Comprehensive Health and Hospital Board, Incorporated CurrentSince Apr 30, 2014 Accepting new patients
Lisa Duke PHD LLC Past Accepting new patients

Locations

86-260 Farrington Hwy
Waianae, HI 96792
Phone (808) 696-7081

Organizations & group practices 4

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": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700611200000",
    "number": "1336207760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86-260 FARRINGTON HWY",
            "city": "WAIANAE",
            "state": "HI",
            "postal_code": "967923128",
            "telephone_number": "808-696-7081",
            "fax_number": "808-696-7093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86-260 FARRINGTON HWY",
            "city": "WAIANAE",
            "state": "HI",
            "postal_code": "967923128",
            "telephone_number": "808-696-7081",
            "fax_number": "808-696-7093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "CHAD",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "HI",
            "license": "PSY1016",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waianae, HI

Sources for this page

Verify at the official NPI Registry.