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MAVIS A MIZUMOTO PH.D.
NPI 1396895900
Psychologist - Clinical in Honolulu, HI

Active since January 12, 2007PECOS EnrolledAccepts Medicare Assignment
1268 YOUNG ST, STE 200, HONOLULU, HI 96814(808) 735-2378(808) 597-8183 Get Directions Write a Review

NPPES record last updated: January 30, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mavis A Mizumoto Ph.d. NPPES

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

MAVIS A MIZUMOTO PH.D. (NPI 1396895900) is an individual clinical provider in Honolulu, Hawaii, licensed in Hawaii (PSY-481) and active in the NPI registry since January 2007. She is enrolled in Medicare PECOS and is a graduate of Other (1985).

NPPES Registry Identity

NPI1396895900
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameMAVIS A MIZUMOTOCredential: PH.D.
Location Address1268 YOUNG ST, STE 200Honolulu, HI 96814-1801
Mailing Address2603 Peter StHonolulu, HI 96816-2013 · (808) 735-2378
Phone(808) 735-2378
Fax(808) 597-8183
Sole ProprietorYes
Medical School CMSOtherGraduated 1985
Enumeration DateJanuary 12, 2007
Last NPPES UpdateJanuary 30, 2017
✔ NPI 1396895900 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in HI · PSY-481
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.
1268 YOUNG ST, Honolulu, HI 96814
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Other Identifiers 11

Other192907HI · Summerlin
Other192907HI · Hma
OtherPSY481-01HI · Desert Mutual
OtherPSY481-01HI · Cigna
OtherC044590-8HI · Hmsa
OtherPSY481-01HI · Mdx
Medicare ID-Type Unspecified55199HI
Medicaid040501-01HI
Other192907HI · Hmn
OtherPSY481-01HI · Uhc
Other0007919184HI · Aetna

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HMSA.Insurance ›

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

Mavis A Mizumoto 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 ID2264456409
PECOS Enrollment IDI20060116000062
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 96814 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

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

DR. LISA LORENE HARTWELL-TINDLE PSYD, RN
Psychologist (Clinical)
1268 YOUNG ST, SUITE 200
HONOLULU, HI 96814
Honolulu County (808) 384-3840

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 Mavis Mizumoto's NPI number?

The NPI number for Mavis Mizumoto is 1396895900. It was assigned to this individual provider in the NPPES registry on January 12, 2007.

Where is Mavis Mizumoto located?

Mavis Mizumoto practices at 1268 Young St Ste 200, Honolulu, HI 96814. The listed phone number is (808) 735-2378.

What is Mavis Mizumoto's specialty?

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

Is Mavis Mizumoto enrolled in Medicare?

Yes. Mavis Mizumoto 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.

What insurance does Mavis Mizumoto accept?

Health plans from HMSA list Mavis Mizumoto as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mavis Mizumoto was last updated on January 30, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years 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.