Individual provider Active NPI

Jaime Stevens, MD, MPH

  • Child & Adolescent Psychiatry Physician
  • Honolulu, HI
National Provider Identifier
1710286489
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
18673 Issued in HI
Practice address
1177 Queen St Apt 2707
Honolulu, HI 96814-4146
Phone
(860) 919-2314
NPI assigned
Mar 21, 2011
Last updated
Feb 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X D0077660 MD
Child & Adolescent Psychiatry Physician 2084P0804X ME132495 FL
Child & Adolescent Psychiatry Physician 2084P0804X 153809 AK
Child & Adolescent Psychiatry Physician 2084P0804X MD60751310 WA
Child & Adolescent Psychiatry Physician 2084P0804X 18673 HI Primary

Addresses

Primary practice location

1177 Queen St Apt 2707
Honolulu, HI 96814-4146

Mailing address

1177 Queen St Apt 2707
Honolulu, HI 96814-4146
Phone (860) 919-2314

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161104001370 HI Practitioner - Psychiatry 7517271612 Reassigns benefits to 4 organizations
I20171110002466 WA Practitioner - Psychiatry 7517271612 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aloha House, Inc.Group PAC ID 8426948316, 15 clinicians
Community Clinic of Maui IncGroup PAC ID 2466365440, 20 clinicians

Practice addresses (Care Compare)

135 S Wakea Ave
Suite 201
Kahului, HI 96732-1385
Phone (808) 249-2121

1881 Nani St
Wailuku, HI 96793-1811
Phone (808) 871-7772

670 Waiale Rd
Apt a
Wailuku, HI 96793-2376
Phone (808) 872-4099

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
153809AKMDChild & Adolescent Psychiatry Physician
ME132495FLMDChild & Adolescent Psychiatry Physician
18673HIMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kitsap Mental Health Services CurrentSince Apr 6, 2022 Accepting new patients
Community Clinic of Maui, Inc. CurrentSince Apr 1, 2022 Accepting new patients
Kauai Veterans Memorial Hospital Current Accepting new patients
Kauai Veterans Memorial Hospital CurrentSince Mar 9, 2023 Accepting new patients
Community Clinic of Maui, Inc. Current Accepting new patients
Community Clinic of Maui, Inc. CurrentSince Apr 1, 2022 Accepting new patients
Aloha House, Inc. CurrentSince Jun 3, 2024 Accepting new patients
Brattleboro Retreat PastSince Mar 11, 2019 Accepting new patients
Youth Eastside Services Past Accepting new patients
Community Clinic of Maui, Inc. PastSince Apr 14, 2024 Accepting new patients

Locations

135 S Wakea Ave
Ste 201
Kahului, HI 96732
Phone (808) 242-1660

1787 Wili Pa Loop
Ste 7
Wailuku, HI 96793
Phone (808) 249-2121

1881 Nani St
Wailuku, HI 96793
Phone (808) 871-7772

5455 Almira Dr NE
Bremerton, WA 98311
Phone (360) 373-5031

Interoperability endpoints

  • Direct secure messaging: jaime.stevens.1@19917.direct.athenahealth.com

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1300665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1710286489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1177 QUEEN ST APT 2707",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968144146",
            "telephone_number": "860-919-2314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1177 QUEEN ST APT 2707",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968144146",
            "telephone_number": "860-919-2314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "JAIME",
        "credential": "MD, MPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-21",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "D0077660",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "FL",
            "license": "ME132495",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "AK",
            "license": "153809",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "WA",
            "license": "MD60751310",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "HI",
            "license": "18673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.