Individual provider Active NPI

Renee Bellis, PSYD

  • Psychologist
  • Honolulu, HI
National Provider Identifier
1396005856
Registry record updated Apr 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1317 Issued in HI
Practice address
850 W Hind Dr Ste 110
Honolulu, HI 96821-1845
Phone
(808) 781-8187
NPI assigned
May 17, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1317 HI Primary

Addresses

Primary practice location

850 W Hind Dr Ste 110
Honolulu, HI 96821-1845

Mailing address

850 W Hind Dr
Suite 110
Honolulu, HI 96821-1855
Phone (808) 781-8187

Other identifiers 1

IdentifierTypeStateIssuer
472910558MedicaidHI

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
I20260303001998 HI Practitioner - Clinical Psychologist 5799930665 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)

850 W Hind Dr
Suite 110
Honolulu, HI 96821-1845
Phone (808) 781-8187

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1317HIMDAcute Care Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1337212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428624000000",
    "number": "1396005856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 W HIND DR",
            "address_2": "SUITE 110",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968211855",
            "telephone_number": "808-781-8187",
            "fax_number": "808-972-5012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 W HIND DR STE 110",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968211845",
            "telephone_number": "808-781-8187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELLIS",
        "first_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-17",
        "last_updated": "2015-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "HI",
            "license": "1317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "472910558",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.