Individual provider Active NPI

Scott Hal Smith, P.A.-C

  • Physician Assistant
  • Wailuku, HI
National Provider Identifier
1295989408
Registry record updated Jan 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
AMD-331 Issued in HI
Practice address
84 N Church St Ste 206
Wailuku, HI 96793
Phone
(808) 281-7477
Fax
(808) 646-7383
NPI assigned
Nov 14, 2008
Last updated
Jan 15, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X AMD-331 HI Primary
Physician Assistant 363A00000X 4221 AZ

Addresses

Primary practice location

84 N Church St Ste 206
Wailuku, HI 96793

Mailing address

711 Kapiolani Blvd Ste 500
Honolulu, HI 96813-5255
Phone (808) 941-3363

Other practice location 1

40 Kupaoa St Unit B-101
Makawao, HI 96768-6215
Phone (808) 281-7477

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
I20090825000125 HI Practitioner - Physician Assistant 3476615535 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aloha Primary Care Physicians and AssociatesGroup PAC ID 0749685535, 2 clinicians

Practice addresses (Care Compare)

24 N Church St
Suite 206
Wailuku, HI 96793-1606
Phone (808) 281-7477

Hospital & facility affiliations

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: scott.smith@20467783892996.direct.elationemr.com

Organizations & group practices 4

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": "1226620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705276800000",
    "number": "1295989408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 KAPIOLANI BLVD STE 500",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968135255",
            "telephone_number": "808-941-3363",
            "fax_number": "808-949-0483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 N CHURCH ST STE 206",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "96793",
            "telephone_number": "808-281-7477",
            "fax_number": "808-646-7383"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40 Kupaoa St Unit B-101",
            "address_purpose": "LOCATION",
            "city": "Makawao",
            "state": "HI",
            "postal_code": "967686215",
            "country_code": "US",
            "telephone_number": "808-281-7477",
            "fax_number": "808-646-7383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SCOTT",
        "middle_name": "HAL",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-14",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "HI",
            "license": "AMD-331",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "4221",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wailuku, HI

Sources for this page

Verify at the official NPI Registry.