Active NPI
Mark Samonsky, MS, ATC
- Sports Medicine (Emergency Medicine) Physician
- Hilo, HI
National Provider Identifier
1114523834
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Emergency Medicine) Physician
- License
- 2000002024
- Practice address
- 556 Waianuenue Ave
Hilo, HI 96720-2522 - Phone
- (808) 313-5500
- NPI assigned
- Dec 8, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Emergency Medicine) Physician | 207PS0010X | 2000002024 | HI | Primary |
Addresses
Primary practice location
556 Waianuenue Ave
Hilo, HI 96720-2522
Mailing address
PO Box 128
Honomu, HI 96728-0128
Phone (808) 936-5391
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2000002024 | HI | MD | Sports Medicine (Emergency Medicine) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607385600000",
"number": "1114523834",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 128",
"city": "HONOMU",
"state": "HI",
"postal_code": "967280128",
"telephone_number": "808-936-5391"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "556 WAIANUENUE AVE",
"city": "HILO",
"state": "HI",
"postal_code": "967202522",
"telephone_number": "808-313-5500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMONSKY",
"first_name": "MARK",
"name_prefix": "Mr.",
"credential": "MS, ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-12-08",
"last_updated": "2020-12-08",
"certification_date": "2020-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "207PS0010X",
"taxonomy_group": "",
"desc": "Emergency Medicine, Sports Medicine",
"state": "HI",
"license": "2000002024",
"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 Dec 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.