Individual provider Active NPI

Linda Tesar-Amimoto

  • Marriage & Family Therapist
  • Wailuku, HI
National Provider Identifier
1619100476
Registry record updated Jan 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
54535 Issued in CA
Practice address
209 Lau Oliwa Loop
Wailuku, HI 96793-2188
Phone
(808) 269-3948
NPI assigned
Aug 27, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 54535 CA Primary

Addresses

Primary practice location

209 Lau Oliwa Loop
Wailuku, HI 96793-2188

Mailing address

209 Lau Oliwa Loop
Wailuku, HI 96793-2188
Phone (808) 269-3948

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
I20240131004754 HI Practitioner - Marriage and Family Therapist 1557760261 Practice locations: Wailuku, HI

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

209 Lau Oliwa Loop
Wailuku, HI 96793-2188
Phone (808) 344-3922

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
54535CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Group Therapy Maui CurrentSince Jan 21, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1251331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641945600000",
    "number": "1619100476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 LAU OLIWA LOOP",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967932188",
            "telephone_number": "808-269-3948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 LAU OLIWA LOOP",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967932188",
            "telephone_number": "808-269-3948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TESAR-AMIMOTO",
        "first_name": "LINDA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-27",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "54535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wailuku, HI

Sources for this page

Verify at the official NPI Registry.