Individual provider Active NPI

Samuel Amsbaugh, PT, DPT

  • Physical Therapist
  • Hilo, HI
National Provider Identifier
1083353486
Registry record updated Jun 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-5452-0 Issued in HI
Practice address
740 Kilauea Ave # 4234
Hilo, HI 96720-4234
Phone
(808) 935-5255
NPI assigned
Jun 2, 2022
Last updated
Jun 2, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT-5452-0 HI Primary

Addresses

Primary practice location

740 Kilauea Ave # 4234
Hilo, HI 96720-4234

Mailing address

740 Kilauea Ave # 4234
Hilo, HI 96720-4234
Phone (808) 935-5255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221102001157 HI Practitioner - Physical Therapist in Private Practice 9830566918 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pakolea LLCGroup PAC ID 6901940709, 2 clinicians

Practice addresses (Care Compare)

215 Railroad Ave
Suite C
Hilo, HI 96720-4513
Phone (808) 935-5255

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-5452-0HIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pakolea LLC Physical Therapist CurrentSince Aug 1, 2022 Accepting new patients
Esser Corp Physical Therapist Past Accepting new patients

Locations

194 Kilauea Ave
Apt 102
Hilo, HI 96720
Phone (808) 935-5255

740 Kilauea Ave
#4234
Hilo, HI 96720
Phone (808) 935-5255

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1654128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654128000000",
    "number": "1083353486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 KILAUEA AVE # 4234",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967204234",
            "telephone_number": "808-935-5255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 KILAUEA AVE # 4234",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967204234",
            "telephone_number": "808-935-5255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMSBAUGH",
        "first_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-02",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "PT-5452-0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilo, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.