NPIMap

Organization Active NPI

Optum Behavioral Care of Ohio, Inc

  • Counseling Psychologist
  • Honolulu, HI
National Provider Identifier
1548036239
Registry record updated Apr 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
Legal business name
OPTUM BEHAVIORAL CARE OF OHIO, INC
Practice address
850 W Hind Dr Ste 210
Honolulu, HI 96821-1845
Phone
(808) 941-9648
Fax
(855) 264-1894
NPI assigned
Dec 4, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2024

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

Authorized official

Name
Kerry Biscornet
Title
Secretary
Phone
(608) 854-2929

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC1900X Primary

Addresses

Primary practice location

850 W Hind Dr Ste 210
Honolulu, HI 96821-1845

Mailing address

11000 Optum Cir
Eden Prairie, MN 55344-2503
Phone (608) 854-2929

Other names 1

  • Optum Xplor Counseling of Hawaii Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250102001885 HI Part B Supplier - Clinic/Group Practice 7719325083 Receives reassigned benefits from 7 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Honolulu, HI

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

98-084 Kamehameha Hwy
Ste 304
Aiea, HI 96701
Phone (808) 486-1020

1130 N Nimitz Hwy
Rm C303
Honolulu, HI 96817
Phone (808) 450-0925

Practitioners & affiliated clinicians

Practitioners 51

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 51

NPI Registry JSON

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

{
    "created_epoch": "1701648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713484800000",
    "number": "1548036239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11000 OPTUM CIR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553442503",
            "telephone_number": "608-854-2929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 W HIND DR STE 210",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968211845",
            "telephone_number": "808-941-9648",
            "fax_number": "855-264-1894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTUM BEHAVIORAL CARE OF OHIO, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-04",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A",
        "authorized_official_last_name": "BISCORNET",
        "authorized_official_first_name": "KERRY",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "608-854-2929"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optum Xplor Counseling of Hawaii",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 19, 2024; 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.

Verify at the official NPI Registry.