Individual provider Active NPI

Mark Daniel Dichner, PH.D.

  • Clinical Psychologist
  • Ewa Beach, HI
National Provider Identifier
1871674465
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
315 Issued in HI
Practice address
91-1009 Kaimoana St
Ewa Beach, HI 96706-6071
Phone
(808) 689-8811
Fax
(808) 689-0316
NPI assigned
Oct 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY315 HI
Clinical Psychologist 103TC0700X 315 HI Primary

Addresses

Primary practice location

91-1009 Kaimoana St
Ewa Beach, HI 96706-6071

Mailing address

91-1009 Kaimoana St
Ewa Beach, HI 96706-6071
Phone (808) 689-8811

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
I20091205000188 HI Practitioner - Clinical Psychologist 3971642828 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

91 -1009 Kaimoana St
Ewa Beach, HI 96706-6071
Phone (808) 689-8811

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
315HIMDClinical Psychologist
PSY315HIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mark Dichner PH D Inc Clinical CurrentSince Apr 19, 2015 Accepting new patients

Locations

98-1238 Kaahumanu St
Ste 405
Pearl City, HI 96782
Phone (808) 689-8811

98-1238 Kaahumanu St
Ste 300
Pearl City, HI 96782
Phone (808) 456-7378

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": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1871674465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91-1009 KAIMOANA ST",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967066071",
            "telephone_number": "808-689-8811",
            "fax_number": "808-689-8811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91-1009 KAIMOANA ST",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967066071",
            "telephone_number": "808-689-8811",
            "fax_number": "808-689-0316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICHNER",
        "first_name": "MARK",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "HI",
            "license": "PSY315",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "HI",
            "license": "315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ewa Beach, HI

Sources for this page

Verify at the official NPI Registry.