Samantha Tavares, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

589 Issued in HI

Practice address

1016 Kapahulu Ave Ste 265
Honolulu, HI 96816-1318

Phone

(808) 342-3377

NPI assigned

May 2, 2007

Last updated

Jun 10, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in HI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Kaiser Foundation Health Plan Inc

  dba Kaiser Honolulu Clinic Radiology

  • Radiology Clinic/Center
  • Honolulu, HI
  • NPI 1063515567
  Medicare reassignment NPD
• Dr Samantha Tavares LLC

  • Clinical Psychologist
  • Honolulu, HI
  • NPI 1760304992
  NPD (past) Authorized official
• Kaiser Foundation Health Plan Inc

  dba Kaiser Koolau Clinic Laboratory

  • Clinical Medical Laboratory
  • Kaneohe, HI
  • NPI 1568477016
  NPD
• Kaiser Foundation Health Plan, Inc

  dba Kahuku Clinic

  • Rural Health Clinic/Center
  • Kahuku, HI
  • NPI 1245773936
  NPD

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1609097781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11215",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968280215",
            "telephone_number": "808-342-3377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1016 KAPAHULU AVE STE 265",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968161318",
            "telephone_number": "808-342-3377"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "43 Oneawa St Ste 211",
            "address_purpose": "LOCATION",
            "city": "Kailua",
            "state": "HI",
            "postal_code": "967342526",
            "country_code": "US",
            "telephone_number": "808-261-3731",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1441 Ala Moana Blvd",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "96814",
            "country_code": "US",
            "telephone_number": "808-432-7600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAVARES",
        "first_name": "SAMANTHA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "HI",
            "license": "589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodhim/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1441 Ala Moana Blvd",
            "city": "Honolulu",
            "state": "HI",
            "country_code": "US",
            "postal_code": "96814",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Courtney Kielemaikalani Taum, M.D.
• Livingstone Tauvao
• Ana Tavares, RBT
• Antone Tavares IV
• Damien Kekaneinoa Tavares III, M.D.
• Yvonne Tavares
• Harry T a Taw, MD
• Brian Tawata, PHARMD.
• Dawn Mari Tawata, LCSW
• Keone Tawata

• Clinical Psychologist in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Clinical Psychologist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.