Individual provider Active NPI

Jesse Blanton, PA-C

  • Physician Assistant
  • Honolulu, HI
National Provider Identifier
1770910705
Registry record updated Oct 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
AMD-711 Issued in HI
Practice address
770 Kapiolani Blvd
Honolulu, HI 96813-5212
Phone
(808) 597-8778
NPI assigned
Oct 4, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X AMD-711 HI Primary

Addresses

Primary practice location

770 Kapiolani Blvd
Honolulu, HI 96813-5212

Mailing address

94-1143 Kaloli Loop
Waipahu, HI 96797-5427
Phone (828) 381-4720

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
I20161031001463 HI Practitioner - Physician Assistant 5991934721 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Medical University of South Carolina College of Medicine, 2013
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)

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

Hospital & facility affiliations

  • Kaiser Foundation Hospital Hospital, Honolulu, HI, CCN 120011

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hawaii Permanente Medical Group Inc CurrentSince Jan 12, 2026 Accepting new patients
Diagnostic Laboratory Services, Inc Past Accepting new patients

Locations

711 Kapiolani Blvd
Honolulu, HI 96813
Phone (808) 432-5312

3288 Moanalua Rd
Honolulu, HI 96819
Phone (808) 265-9205

401 Kamokila Blvd
Kapolei, HI 96707
Phone (808) 432-2000

Organizations & group practices 3

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.

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": "1380844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538956800000",
    "number": "1770910705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94-1143 KALOLI LOOP",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967975427",
            "telephone_number": "828-381-4720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 KAPIOLANI BLVD",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968135212",
            "telephone_number": "808-597-8778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANTON",
        "first_name": "JESSE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-04",
        "last_updated": "2018-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "HI",
            "license": "AMD-711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.