NPIMap

Organization Active NPI

Psychiatric Associates

Doing business as Advanced Psychiatry and Addiction Medicine

  • Psychiatry Physician
  • Aiea, HI
National Provider Identifier
1740857101
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
PSYCHIATRIC ASSOCIATES
Doing business as
Advanced Psychiatry and Addiction Medicine
Practice address
98-1247 Kaahumanu St Ste 116
Aiea, HI 96701-5300
Phone
(808) 762-0911
Fax
(808) 626-5161
NPI assigned
Jun 4, 2021
Last updated
Mar 15, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
PSYCHIATRIC ASSOCIATESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 15, 2023

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

Authorized official

Name
Cindy Wu, RN
Title
Clinical Manager
Phone
(808) 728-0484

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X NU
Psychiatry Physician 2084P0800X NU Primary
Child & Adolescent Psychiatry Physician 2084P0804X NU

Addresses

Primary practice location

98-1247 Kaahumanu St Ste 116
Aiea, HI 96701-5300

Mailing address

98-1247 Kaahumanu St Ste 116
Aiea, HI 96701-5300
Phone (808) 762-0911

Other identifiers 1

IdentifierTypeStateIssuer
001356MedicaidHI

Other names 1

  • Advanced Psychiatry and Addiction Medicine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230531000523 HI Part B Supplier - Clinic/Group Practice 6406213834 Receives reassigned benefits from 6 practitioners
Practice locations: Aiea, HI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
12D2237950Psychiatric Associates LLC98-1247 Kaahumanu Street #116, Aiea, HI 96701Certificate of waiverSep 28, 2027

National Provider Directory

National Provider Directory
Part of
Psychiatric Associates

Locations

98-1247 Kaahumanu St
Ste 110A
Aiea, HI 96701
Phone (808) 554-5688

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1622764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678838400000",
    "number": "1740857101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98-1247 KAAHUMANU ST STE 116",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967015300",
            "telephone_number": "808-762-0911",
            "fax_number": "808-626-5161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98-1247 KAAHUMANU ST STE 116",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967015300",
            "telephone_number": "808-762-0911",
            "fax_number": "808-626-5161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHIATRIC ASSOCIATES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PSYCHIATRIC ASSOCIATES",
        "enumeration_date": "2021-06-04",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A",
        "authorized_official_last_name": "WU",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "CLINICAL MANAGER",
        "authorized_official_telephone_number": "808-728-0484",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001356",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Psychiatry and Addiction Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Aiea, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.