Active NPI
Cathy Moonshine, PHD
- Clinical Psychologist
- Hilo, HI
National Provider Identifier
1598278376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1652
- Practice address
- 305 Wailuku Dr Ste 3
Hilo, HI 96720-2488 - Phone
- (808) 698-6081
- NPI assigned
- Nov 15, 2017
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1652 | HI | Primary |
Addresses
Primary practice location
305 Wailuku Dr Ste 3
Hilo, HI 96720-2488
Mailing address
305 Wailuku Dr Ste 3
Hilo, HI 96720-2488
Phone (808) 740-2244
Other practice location 1
9620 NE Tanasbourne Dr Ste 300
Hillsboro, OR 97124-7844
Phone (808) 698-8061
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180419001599 | HI | Practitioner - Clinical Psychologist | 4981975968 | Practice locations: Hilo, HI |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
305 Wailuku Dr
Suite 3
Hilo, HI 96720-2488
Phone (808) 698-6081
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1652 | HI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698019200000",
"number": "1598278376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 WAILUKU DR STE 3",
"city": "HILO",
"state": "HI",
"postal_code": "967202488",
"telephone_number": "808-740-2244",
"fax_number": "877-897-6124"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 WAILUKU DR STE 3",
"city": "HILO",
"state": "HI",
"postal_code": "967202488",
"telephone_number": "808-698-6081"
}
],
"practiceLocations": [
{
"address_1": "9620 NE Tanasbourne Dr Ste 300",
"address_purpose": "LOCATION",
"city": "Hillsboro",
"state": "OR",
"postal_code": "971247844",
"country_code": "US",
"telephone_number": "808-698-8061",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOONSHINE",
"first_name": "CATHY",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-11-15",
"last_updated": "2023-10-23",
"certification_date": "2023-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "HI",
"license": "1652",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hilo, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.