Antonio Gino, PH.D., CSAC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY-475 Issued in HI

Practice address

1154 Fort Street Mall Ste 206
Honolulu, HI 96813-2712

Phone

(808) 528-1184

NPI assigned

May 12, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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.

• Gino Clinic

  • Psychologist
  • Honolulu, HI
  • NPI 1548527617
  NPD Authorized official
• Gino Clinic, LLC

  • Clinical Psychologist
  • Honolulu, HI
  • NPI 1649012295
  NPD Authorized official

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1679523153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25972",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968250972",
            "telephone_number": "808-528-1184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1154 FORT STREET MALL STE 206",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132712",
            "telephone_number": "808-528-1184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GINO",
        "first_name": "ANTONIO",
        "name_prefix": "Dr.",
        "credential": "PH.D., CSAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "HI",
            "license": "PSY-475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00137401",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gino Clinic
• Gino Clinic, LLC
• Alexander Gino
• Alissa Gino, LMHC
• Amanda Maria Gino
• Peter Tsuneo Ginoza, MED
• Scott Ginoza, M.S.
• Lori Kristine Giorgio
• Willa Giorgio
• Joseph Giovannoni, APRN RX

• Clinical Psychologist in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Clinical Psychologist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.