Active NPI
Elnur Gajiev, PSYD
- Psychologist
- Honomu, HI
National Provider Identifier
1891130852
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Practice address
- 28-1672 Old Mamalahoa Hwy
Back Building, 2ND Floor
Honomu, HI 96728 - Phone
- (347) 602-2596
- NPI assigned
- May 3, 2013
- Last updated
- Mar 23, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | NU | Primary |
Addresses
Primary practice location
28-1672 Old Mamalahoa Hwy
Back Building, 2ND Floor
Honomu, HI 96728
Mailing address
PO Box 831153
Pepeekeo, HI 96783-1072
Phone (347) 602-2596
Other practice location 1
2450 S Vine St
Denver, CO 80210-5264
Phone (303) 871-3626
Other practice location 2
15 Kanoa St
Hilo, HI 96720-2426
Phone (347) 602-2596
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
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, 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": "1367539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1584921600000",
"number": "1891130852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 831153",
"city": "PEPEEKEO",
"state": "HI",
"postal_code": "967831072",
"telephone_number": "347-602-2596"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28-1672 OLD MAMALAHOA HWY",
"address_2": "BACK BUILDING, 2ND FLOOR",
"city": "HONOMU",
"state": "HI",
"postal_code": "96728",
"telephone_number": "347-602-2596"
}
],
"practiceLocations": [
{
"address_1": "2450 S Vine St",
"address_purpose": "LOCATION",
"city": "Denver",
"state": "CO",
"postal_code": "802105264",
"country_code": "US",
"telephone_number": "303-871-3626",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "15 Kanoa St",
"address_purpose": "LOCATION",
"city": "Hilo",
"state": "HI",
"postal_code": "967202426",
"country_code": "US",
"telephone_number": "347-602-2596",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GAJIEV",
"first_name": "ELNUR",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-05-03",
"last_updated": "2020-03-23",
"certification_date": "2020-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Honomu, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.