MARK D BREITHAUPT PHD INC
NPI 1902115082
Psychologist - Clinical in Wailuku, HI

Q: What is Mark D Breithaupt Phd Inc's NPI number?

The NPI number for Mark D Breithaupt Phd Inc is 1902115082. It was assigned to this organization in the NPPES registry on October 6, 2010.

Q: What is Mark D Breithaupt Phd Inc's specialty?

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

Active since October 06, 2010

2200 MAIN ST, 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: October 25, 2026.

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

On this page

About Mark D Breithaupt Phd Inc NPPES

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

MARK D BREITHAUPT PHD INC (NPI 1902115082) is a healthcare organization registered as a clinical in Wailuku, Hawaii and active in the NPI registry since October 2010. The organization lists Mark Douglas Breithaupt, Licensed Clinical Psychologist, as its authorized official.

NPPES Registry Identity

NPI1902115082

Entity TypeOrganization

Primary Taxonomy103TC0700X

Legal Business NameMARK D BREITHAUPT PHD INC

Location Address2200 MAIN STWailuku, HI 96793-1681

Mailing AddressPo Box 2632Wailuku, HI 96793-7632 · (808) 205-8403

Phone(808) 205-8403

Organization SubpartNo

Authorized OfficialMark Douglas BreithauptLicensed Clinical Psychologist · (808) 205-8403

Enumeration DateOctober 6, 2010

Last NPPES UpdateMay 19, 20252 updates tracked since enumeration

NPPES CertifiedMay 19, 2025

✔ NPI 1902115082 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 · PSY499

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.

2200 MAIN ST, Wailuku, HI 96793

Open in Google Maps ↗

Other Identifiers 2

Medicaid03451701HI

OtherHMSAHI · Hmsa

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mark D Breithaupt Phd Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Mark D Breithaupt Phd Inc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Mark Breithaupt, PH.D.

Clinical Psychologist

NPI 1053436337

2200 MAIN ST STE 510
Wailuku, HI 96793

(808) 205-8403

✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 D Breithaupt Phd Inc's NPI number?

The NPI number for Mark D Breithaupt Phd Inc is 1902115082. It was assigned to this organization in the NPPES registry on October 6, 2010.

Where is Mark D Breithaupt Phd Inc located?

Mark D Breithaupt Phd Inc is located at 2200 Main St, Wailuku, HI 96793. The listed phone number is (808) 205-8403.

What is Mark D Breithaupt Phd Inc's specialty?

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

Is Mark D Breithaupt Phd Inc enrolled in Medicare?

Yes. Mark D Breithaupt Phd Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Mark D Breithaupt Phd Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Mark D Breithaupt Phd Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Mark D Breithaupt Phd Inc 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 17 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.