Individual provider Active NPI

Nicole Matsui, PA-C

  • Medical Physician Assistant
  • Kihei, HI
National Provider Identifier
1700620648
Registry record updated Aug 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1484 Issued in HI
Practice address
1300 N Holopono St Ste 215
Kihei, HI 96753-6945
Phone
(808) 874-3444
NPI assigned
Jun 25, 2024
Last updated
Aug 27, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1484 HI Primary

Addresses

Primary practice location

1300 N Holopono St Ste 215
Kihei, HI 96753-6945

Mailing address

1300 N Holopono St Ste 215
Kihei, HI 96753-6945
Phone (808) 874-3444

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
I20251110001679 HI Practitioner - Physician Assistant 7517457393 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amy Reisenauer MD LLCGroup PAC ID 3173892809, 7 clinicians

Practice addresses (Care Compare)

1300 N Holopono St
Suite 215
Kihei, HI 96753-6945
Phone (808) 874-3444

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1484HIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Oculofacial Plastic Surgery of Hawaii Inc CurrentSince Oct 1, 2025 Accepting new patients
Amy Reisenauer MD LLC CurrentSince Oct 1, 2025 Accepting new patients

Locations

1300 N Holopono St
Ste 215
Kihei, HI 96753
Phone (808) 874-3444

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1719273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787788800000",
    "number": "1700620648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 N HOLOPONO ST STE 215",
            "city": "KIHEI",
            "state": "HI",
            "postal_code": "967536945",
            "telephone_number": "808-874-3444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N HOLOPONO ST STE 215",
            "city": "KIHEI",
            "state": "HI",
            "postal_code": "967536945",
            "telephone_number": "808-874-3444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATSUI",
        "first_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-25",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "HI",
            "license": "1484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kihei, HI

Sources for this page

Verify at the official NPI Registry.