YURIE I VAN DERMARK PSYD
NPI 1720503576
Psychologist - Clinical in Honolulu, HI

Q: What is Yurie Van Dermark's NPI number?

The NPI number for Yurie Van Dermark is 1720503576. It was assigned to this individual provider in the NPPES registry on August 12, 2017.

Q: What is Yurie Van Dermark's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Yurie Van Dermark was last updated on March 18, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since August 12, 2017PECOS Enrolled

1050 QUEEN ST STE 100, HONOLULU, HI 96814(808) 692-3628 Get Directions Write a Review

NPPES record last updated: March 18, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Mar 18, 2026, Feb 13, 2023, Aug 12, 2017 (3 updates tracked since 2017).

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About Yurie I Van Dermark Psyd NPPES

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

YURIE I VAN DERMARK PSYD (NPI 1720503576) is an individual clinical provider in Honolulu, Hawaii, licensed in Hawaii (PSY-2060-0) and active in the NPI registry since August 2017. She is enrolled in Medicare PECOS and maintains a secondary practice location in Honolulu.

NPPES Registry Identity

NPI1720503576

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameYURIE I VAN DERMARKCredential: PSYD

Location Address1050 QUEEN ST STE 100Honolulu, HI 96814-4130

Mailing Address1050 Queen St Ste 100Honolulu, HI 96814-4130 · (808) 692-3628

Phone(808) 692-3628

Sole ProprietorNo

Enumeration DateAugust 12, 2017

Last NPPES UpdateMarch 18, 20263 updates tracked since enumeration

NPPES CertifiedMarch 18, 2026

✔ NPI 1720503576 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-2060-0

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 ListedCounselor · Mental HealthTaxonomy 101YM0800X

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

1050 QUEEN ST STE 100, Honolulu, HI 96814

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Secondary Practice Location 1

Location 11750 Kalakaua AveHonolulu, HI 96826-3766 · Phone (808) 758-5174

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Yurie I Van Dermark Psyd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 20

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

DR. ALEXANDRIA LEEDY PSY.D.

Psychologist (Clinical)