MR. CONRAD WK MORENO (PHD) – Psychologist, NPI 1114160140

MR. CONRAD WK MORENO (PHD) is a healthcare provider. based in Honolulu, Hawaii. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PHD. They hold a License No. 1064 (HI). The NPI Number for MR. CONRAD WK MORENO (PHD) is 1114160140

Main info

Male
21 Years Of Experience
Accepts Medicare Assignment
Name
MR. CONRAD WK MORENO (PHD)
NPI
1114160140
Phone
(808) 922-4787
Address
277 OHUA AVE
Enumeration Date
6 April 2009
Last Update Date
9 June 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2005 (21 years ago)
PAC ID
3870647753
Group Practice PAC ID
9335058536
Professional Enrollment ID
I20090811000580
Address ID
HI968153643HO277XXAVEX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness75
Years active:17State licenses:1Digital endpointsOther names

306 CLINICAL PSYCHOLOGIST in HI

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Provider Addresses for MR. CONRAD WK MORENO (PHD)

  • 277, Ohua Avenue, Kapahulu, Honolulu, Honolulu County, Hawaii, 96815, United States

    HONOLULU, HI 968153643

    Phone: (808) 922-4787

    Fax: (808) 922-4950

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2009-08-11

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20090811000580IClinical PsychologistHITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 96815)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9335058536View full group profile
NameSpecialtyState
Physician AssistantHI
Clinical Social WorkerHI
Physician AssistantHI
Registered Dietitian Or Nutrition ProfessionalHI
Internal MedicineHI
Endocrinology, Internal MedicineAZ
Internal MedicineHI
Clinical PsychologistHI
Physician AssistantHI
Internal MedicineHI

Reviews

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Frequently asked questions

Does MR. CONRAD WK MORENO (PHD) have a public NPI I can cite?
Public records show MR. CONRAD WK MORENO (PHD) under NPI 1114160140.
Does the public listing show MR. CONRAD WK MORENO (PHD) as active?
MR. CONRAD WK MORENO (PHD)'s NPI record reflects an active status in NPPES.
What type of care does MR. CONRAD WK MORENO (PHD) provide?
MR. CONRAD WK MORENO (PHD)'s profile centers on Psychologist. Clinical services aligned with this taxonomy classification.
What geographic area is tied to MR. CONRAD WK MORENO (PHD)?
MR. CONRAD WK MORENO (PHD) is associated with Honolulu, Hawaii in the same public data insurers reference.
Why is information missing for MR. CONRAD WK MORENO (PHD)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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