Jessica Emily Hennen, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

AMD-1585 Issued in HI

Practice address

95-390 Kuahelani Ave Ste J-1
Mililani, HI 96789-1192

Phone

(808) 909-3252

Fax

(808) 909-3894

NPI assigned

Oct 30, 2020

Last updated

Mar 5, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NH, HI2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Grima Dermatology and Surgery IncGroup PAC ID 4082198569, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Grima Dermatology and Surgery Inc

  • Dermatology Physician
  • Mililani, HI
  • NPI 1487514394
  Medicare reassignment Care Compare group
• David J Mols RPT Inc

  • Physical Therapy Clinic/Center
  • Aiea, HI
  • NPI 1154760643
  NPD
• Dermatology Specialists of Hawaii, LLC

  dba Hawaii Dermatology and Surgery

  • Medical Specialty Clinic/Center
  • Aiea, HI
  • NPI 1891506739
  NPD

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

{
    "created_epoch": "1604016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772668800000",
    "number": "1205436011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91-1086 KEKAIHOLO ST",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967066214",
            "telephone_number": "808-909-3252",
            "fax_number": "808-909-3894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95-390 KUAHELANI AVE STE J-1",
            "city": "MILILANI",
            "state": "HI",
            "postal_code": "967891192",
            "telephone_number": "808-909-3252",
            "fax_number": "808-909-3894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNEN",
        "first_name": "JESSICA",
        "middle_name": "EMILY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-30",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "EL31989",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "HI",
            "license": "AMD-1585",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA2112",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Heflin
• Hele Health LLC
• Stacy Ihilani Helepololei, RN
• Mary Grace Heleski
• Noah Heleski
• Kina Hensley
• Caroline Hernandez
• Hiedi Hernandez
• Michael Herrera
• Yonie Keala Herrera, MHC

• Physician Assistant in Mililani, HI
• Providers in Mililani, HI by specialty
• Physician Assistant in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.