Dr Mark Douglas Breithaupt, PHD in Wailuku, HI - Medicare Psychologist Provider

Dr Mark Douglas Breithaupt, PHD is a medicare enrolled "Psychologist - Clinical" provider in Wailuku, Hawaii. His current practice location is 2200 Main St Ste 510, Wailuku, Hawaii. You can reach out to his office (for appointments etc.) via phone at (808) 205-8403.

Dr Mark Douglas Breithaupt is licensed to practice in Hawaii (license number PSY 499) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1053436337.

Contact Information

	Dr Mark Douglas Breithaupt, PHD
	2200 Main St Ste 510, Wailuku, HI 96793-1624
	(808) 205-8403
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Mark Douglas Breithaupt
Gender	Male
Speciality	Psychologist - Clinical
Location	2200 Main St Ste 510, Wailuku, Hawaii
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1053436337
Provider Enumeration Date: 03/19/2007
Last Update Date: 05/19/2025

Medicare PECOS Information:

PECOS PAC ID: 2264455120
Enrollment ID: I20060106000439

Medical Identifiers

Medical identifiers for Dr Mark Douglas Breithaupt such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1053436337	NPI	-	NPPES
03451701	Medicaid	HI
A 3812-3	Other	HI	HMSA

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103T00000X	Psychologist	PSY 499 (Hawaii)	Secondary
106H00000X	Marriage & Family Therapist	PSY 499 (Hawaii)	Secondary
103TC0700X	Psychologist - Clinical	PSY 499 (Hawaii)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Mark Douglas Breithaupt allows following entities to bill medicare on his behalf.

Entity Name	Mark D Breithaupt Phd Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1902115082 PECOS PAC ID: 8123208618 Enrollment ID: O20110216000359

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Mark Douglas Breithaupt is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Mark Douglas Breithaupt, PHD Po Box 2632, Wailuku, HI 96793-7632 Ph: (808) 205-8403	Dr Mark Douglas Breithaupt, PHD 2200 Main St Ste 510, Wailuku, HI 96793-1624 Ph: (808) 205-8403

Reviews and Comments

Psychologist in Wailuku, HI

Joseph Cosner, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 81 N Market St, Wailuku, HI 96793 Phone: 808-244-2330 Fax: 808-244-2254
Shaela Sakamoto, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 270 Hookahi St Ste 211, Wailuku, HI 96793 Phone: 808-740-3860
Rachel Kaya, PHD Psychologist Medicare: Accepting Medicare Assignments Practice Location: 55 Maui Lani Pkwy, Wailuku, HI 96793 Phone: 808-243-6420 Fax: 808-243-6429
Dr. Deanna Mirzai-nagasaka, PSY.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1939 E Vineyard St, Wailuku, HI 96793 Phone: 808-249-2431
Laurie Keiko Omuro-yamamoto, PH.D. Psychologist Medicare: Accepting Medicare Assignments Practice Location: 1787 Wili Pa Loop Ste 7, Wailuku, HI 96793 Phone: 808-249-2121 Fax: 808-242-8920
Derik Tyrone Bell, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 550 Kaikoo Pl, Wailuku, HI 96793 Phone: 180-845-9291

Dr Mark Douglas Breithaupt, PHD - Medicare Psychologist in Wailuku, HI