Individual provider Active NPI

Samantha Christine Hyde Duhaylonsod, APRN

  • Family Nurse Practitioner
  • Haleiwa, HI
National Provider Identifier
1154104594
Registry record updated Aug 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN-4196 Issued in HI
Practice address
66-125 Kamehameha Hwy
Haleiwa, HI 96712-1601
Phone
(808) 691-8501
NPI assigned
Aug 18, 2023
Last updated
Aug 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN-4196 HI Primary

Addresses

Primary practice location

66-125 Kamehameha Hwy
Haleiwa, HI 96712-1601

Mailing address

91-3575 Kauluakoko St Unit 1504
Ewa Beach, HI 96706-5861
Phone (808) 741-8600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231115002845 HI Practitioner - Nurse Practitioner 0648627489 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Queens University Medical GroupGroup PAC ID 2466831557, 614 clinicians

Practice addresses (Care Compare)

1380 Lusitana St
Honolulu, HI 96813-2448

66-125 Kamehameha Hwy
Haleiwa, HI 96712-1601
Phone (808) 637-5087

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN-4196HIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Queens University Medical Group CurrentSince Nov 1, 2023 Accepting new patients

Locations

66-125 Kamehameha Hwy
Haleiwa, HI 96712
Phone (808) 225-0725

1301 Punchbowl St
Honolulu, HI 96813
Phone (808) 538-9011

1380 Lusitana St
Ste 913
Honolulu, HI 96813
Phone (808) 691-8521

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1692316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1154104594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91-3575 KAULUAKOKO ST UNIT 1504",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967065861",
            "telephone_number": "808-741-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66-125 KAMEHAMEHA HWY",
            "city": "HALEIWA",
            "state": "HI",
            "postal_code": "967121601",
            "telephone_number": "808-691-8501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUHAYLONSOD",
        "first_name": "SAMANTHA",
        "middle_name": "CHRISTINE HYDE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-18",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "APRN-4196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Haleiwa, HI

Sources for this page

Verify at the official NPI Registry.