Samuel Ernest William Johnsen, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD12422 Issued in HI

Practice address

180 Dickenson St Ste 103
Lahaina, HI 96761-1215

Phone

(808) 214-5985

Fax

(808) 214-6766

NPI assigned

Jul 19, 2006

Last updated

Oct 2, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bayada Home Health Care Home health agency, Wailuku, HI, CCN 127309
• Maui Memorial Medical Center Hospital, Wailuku, HI, CCN 120002

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: samuel.johnsen.1@23912.direct.athenahealth.com

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.

• Laulea Health Center LLC

  • Medical Specialty Clinic/Center
  • Lahaina, HI
  • NPI 1982105052
  Medicare reassignment NPD Authorized official

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

• B.C.P., Inc.

  dba BAYADA Home Health Care

  • Home Health Agency
  • Wailuku, HI
  • NPI 1942569702
  Care Compare affiliation
• Maui Health System a Kaiser Foundation Hospitals LLC

  dba Maui Memorial Medical Center

  • General Acute Care Hospital
  • Wailuku, HI
  • NPI 1013379460
  Care Compare affiliation

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538438400000",
    "number": "1669491858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 DICKENSON ST STE 103",
            "city": "LAHAINA",
            "state": "HI",
            "postal_code": "967611215",
            "telephone_number": "808-214-5985",
            "fax_number": "808-214-6766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 DICKENSON ST STE 103",
            "city": "LAHAINA",
            "state": "HI",
            "postal_code": "967611215",
            "telephone_number": "808-214-5985",
            "fax_number": "808-214-6766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSEN",
        "first_name": "SAMUEL",
        "middle_name": "ERNEST WILLIAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2018-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "MD12422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHA",
            "identifier": "824532282",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "00C0241160",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "824532282",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMAA",
            "identifier": "824532282",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMA",
            "identifier": "824532282",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sandra Lee Ignacio, M.S., LIC.ACU.
• Dennis N Ishimoto, D.D.S.
• Jacoby Inc.
• John D Dodson DDS Inc
• John D Dodson, D.D.S. Inc.
• Yvonne E Johnston, RPH
• Kaanapali Medical Services Inc (Doctors On Call)
• Glenn Y. Kadohiro, DDS
• Kahana Family Dental Center, Inc.
• Kahana Physical Therapy Center,Inc

• Internal Medicine Physician in Lahaina, HI
• Providers in Lahaina, HI by specialty
• Internal Medicine Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2018; 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.