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DR. MARK DOUGLAS BREITHAUPT PH.D.
NPI 1053436337
Psychologist - Clinical in Wailuku, HI

Active since March 19, 2007PECOS EnrolledAccepts Medicare Assignment
2200 MAIN ST STE 510, WAILUKU, HI 96793(808) 205-8403 Get Directions Write a Review

NPPES record last updated: May 19, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 19, 2025, Sep 9, 2019 (2 updates tracked since 2019).

About Dr. Mark Douglas Breithaupt Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MARK DOUGLAS BREITHAUPT PH.D. (NPI 1053436337) is an individual clinical provider in Wailuku, Hawaii, licensed in Hawaii (PSY 499) and active in the NPI registry since March 2007. He is enrolled in Medicare PECOS and is a graduate of Other (1999).

NPPES Registry Identity

NPI1053436337
Entity TypeIndividualMale
Primary Taxonomy103TC0700X
Provider Legal NameDR. MARK DOUGLAS BREITHAUPTCredential: PH.D.
Location Address2200 MAIN ST STE 510Wailuku, HI 96793-1624
Mailing AddressPo Box 2632Wailuku, HI 96793-7632 · (808) 205-8403
Phone(808) 205-8403
Sole ProprietorNo
Medical School CMSOtherGraduated 1999
Enumeration DateMarch 19, 2007
Last NPPES UpdateMay 19, 20252 updates tracked since enumeration
NPPES CertifiedMay 19, 2025
✔ NPI 1053436337 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in HI · PSY 499
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
Also ListedPsychologistTaxonomy 103T00000X · License PSY 499 (HI)
Also ListedMarriage & Family TherapistTaxonomy 106H00000X · License PSY 499 (HI)
2200 MAIN ST STE 510, Wailuku, HI 96793
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Other Identifiers 2

Medicaid03451701HI
OtherA 3812-3HI · Hmsa

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Mark Douglas Breithaupt Ph.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2264455120
PECOS Enrollment IDI20060106000439
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 96793 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$180.05 typical visit price
range $60.53 – $180.05
Typical copayment $45.01 (range $15.13 – $45.01)
Most-billed visit code 99205
Established Patient
$105.65 typical visit price
range $20.09 – $147.56
Typical copayment $26.41 (range $5.02 – $36.89)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARK D BREITHAUOT PHD LLC
Psychologist (Clinical)
2200 MAIN ST STE 510
WAILUKU, HI 96793
Maui County (808) 205-8403
DR. SUSAN FRIEDER PH.D.
Psychologist (Clinical)
2200 MAIN ST STE 510
WAILUKU, HI 96793
Maui County (808) 243-0888

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mark Breithaupt's NPI number?

The NPI number for Mark Breithaupt is 1053436337. It was assigned to this individual provider in the NPPES registry on March 19, 2007.

Where is Mark Breithaupt located?

Mark Breithaupt practices at 2200 Main St Ste 510, Wailuku, HI 96793. The listed phone number is (808) 205-8403.

What is Mark Breithaupt's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Mark Breithaupt enrolled in Medicare?

Yes. Mark Breithaupt is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Mark Breithaupt was last updated on May 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.