Individual provider Active NPI

Samantha Scaduto Hensley, PA-C

  • Physician Assistant
  • Honolulu, HI
National Provider Identifier
1275107153
Registry record updated Oct 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
AMD-1354 Issued in HI
Practice address
770 Kapiolani Blvd Ste 705
Honolulu, HI 96813-5241
Phone
(808) 597-8791
NPI assigned
May 16, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X AMD-1354 HI Primary
Physician Assistant 363A00000X 1164421 MA
Medical Physician Assistant 363AM0700X PA01498 RI

Addresses

Primary practice location

770 Kapiolani Blvd Ste 705
Honolulu, HI 96813-5241

Mailing address

770 Kapiolani Blvd Ste 705
Honolulu, HI 96813-5241
Phone (808) 597-8791

Other practice location 1

1010 Pensacola St
Honolulu, HI 96814-2118
Phone (833) 833-3333

Other practice location 2

401 Kamokila Blvd
Kapolei, HI 96707-5607
Phone (833) 833-3333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, 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

Enrollment IDStateProvider typePAC IDDetails
I20221103001490 RI Practitioner - Physician Assistant 9830596147
I20240522004052 HI Practitioner - Physician Assistant 9830596147 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hawaii Permanente Medical Group IncGroup PAC ID 7618880667, 705 clinicians

Practice addresses (Care Compare)

3288 Moanalua Rd
Honolulu, HI 96819-1469
Phone (808) 432-0000

401 Kamokila Blvd
Kapolei, HI 96707-5607
Phone (808) 432-3600

Merit-based Incentive Payment System (MIPS)

Final score
96.45 of 100Reported as group
Quality
85.46
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1164421MAMDPhysician Assistant

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1621123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761523200000",
    "number": "1275107153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 KAPIOLANI BLVD STE 705",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968135241",
            "telephone_number": "808-597-8791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 KAPIOLANI BLVD STE 705",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968135241",
            "telephone_number": "808-597-8791"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1010 Pensacola St",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968142118",
            "country_code": "US",
            "telephone_number": "833-833-3333",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "401 Kamokila Blvd",
            "address_purpose": "LOCATION",
            "city": "Kapolei",
            "state": "HI",
            "postal_code": "967075607",
            "country_code": "US",
            "telephone_number": "833-833-3333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENSLEY",
        "first_name": "SAMANTHA",
        "middle_name": "SCADUTO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-16",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "HI",
            "license": "AMD-1354",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "1164421",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "RI",
            "license": "PA01498",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.