Active NPI
Raymond Lee Levister, PH.D.
- Psychologist
- Honolulu, HI
National Provider Identifier
1447460340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY-823
- Practice address
- 210 Ward Ave
#124
Honolulu, HI 96814-4008 - Phone
- (808) 489-5558
- Fax
- (808) 585-0379
- NPI assigned
- May 22, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY-823 | HI | Primary |
Addresses
Primary practice location
210 Ward Ave
#124
Honolulu, HI 96814-4008
Mailing address
445 Seaside Ave
# 2518
Honolulu, HI 96815-2640
Phone (808) 489-5558
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 990339751-96813-B004 | Other | HI | TRICARE |
| 0000246991 | Other | HI | HMSA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in HI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110601000853 | HI | Practitioner - Psychologist Billing Independently | 2769669688 | Practice locations: Honolulu, HI |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302480000000",
"number": "1447460340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "445 SEASIDE AVE",
"address_2": "# 2518",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968152640",
"telephone_number": "808-489-5558",
"fax_number": "808-585-0379"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 WARD AVE",
"address_2": "#124",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968144008",
"telephone_number": "808-489-5558",
"fax_number": "808-585-0379"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEVISTER",
"first_name": "RAYMOND",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-22",
"last_updated": "2011-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "HI",
"license": "PSY-823",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "990339751-96813-B004",
"state": "HI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HMSA",
"identifier": "0000246991",
"state": "HI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Honolulu, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.