Individual provider Active NPI

Jason M Andrus, MD

  • Psychiatry Physician
  • Wailuku, HI
National Provider Identifier
1629148713
Registry record updated Nov 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
220851 Issued in MA
Practice address
221 Mahalani Street
Wailuku, HI 96793-2526
Phone
(808) 244-9056
NPI assigned
Nov 8, 2006
Last updated
Nov 5, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 220851 MA Primary
Child & Adolescent Psychiatry Physician 2084P0804X 220851 MA

Addresses

Primary practice location

221 Mahalani Street
Wailuku, HI 96793-2526

Mailing address

221 Mahalani Street
Behavioral Health Services
Wailuku, HI 96793-2526
Phone (808) 442-5473

Other identifiers 1

IdentifierTypeStateIssuer
50055505MedicaidHI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150108001051 NY Practitioner - Psychiatry 5799785770 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
State University of New York at Buffalo School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

75 -59
Glen Oaks, NY 11004-1150
Phone (718) 470-8100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
220851MAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Sep 1, 2015 Accepting new patients
Northern Westchester Hospital Association Psychiatry CurrentSince Oct 6, 2018 Accepting new patients
Northern Westchester Hospital Association CurrentSince Oct 6, 2018 Accepting new patients
North Shore - Lij Medical PC CurrentSince Sep 1, 2015 Accepting new patients
Northern Westchester Hospital Association Current Accepting new patients
Psychiatric Associates of Malden, P.C. Psychiatry Past Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

7559 263rd St
Glen Oaks, NY 11004
Phone (718) 470-8005

300 Community Dr
Manhasset, NY 11030

400 E Main St
Mount Kisco, NY 10549
Phone (914) 666-1200

972 Brush Hollow Rd
Westbury, NY 11590

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 6

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257379200000",
    "number": "1629148713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 MAHALANI STREET",
            "address_2": "BEHAVIORAL HEALTH SERVICES",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967932526",
            "telephone_number": "808-442-5473",
            "fax_number": "808-242-2488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 MAHALANI STREET",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967932526",
            "telephone_number": "808-244-9056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRUS",
        "first_name": "JASON",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2009-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "220851",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MA",
            "license": "220851",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "50055505",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wailuku, HI

Sources for this page

Verify at the official NPI Registry.