Individual provider Active NPI

Mary Leilani Yoshiko Gutierrez, A.P.R.N.

  • Nurse Practitioner
  • Honolulu, HI
National Provider Identifier
1306903273
Registry record updated Sep 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4513 Issued in MN
Practice address
500 Ala Moana Blvd Ste 1300
Honolulu, HI 96813-4912
Phone
(808) 528-3657
Fax
(808) 524-6552
NPI assigned
Jan 2, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN433 HI
Nurse Practitioner 363L00000X 4513 MN Primary

Addresses

Primary practice location

500 Ala Moana Blvd Ste 1300
Honolulu, HI 96813-4912

Mailing address

500 Ala Moana Blvd Ste 1300
Honolulu, HI 96813-4912
Phone (808) 528-3657

Other practice location 1

500 Ala Moana Blvd Ste 1-302
Honolulu, HI 96813-4925
Phone (808) 528-3657

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
I20120111000825 HI Practitioner - Nurse Practitioner 1254508401 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tada Anesthesia ServicesGroup PAC ID 0547761728, 2 clinicians

Practice addresses (Care Compare)

1441 Kapiolani Blvd
Suite 2020
Honolulu, HI 96814-4408
Phone (808) 272-7744

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4513MNMDPhysical Therapist
APRN433HIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Honolulu Pain Management Clinic, L.L.C. CurrentSince Sep 26, 2025 Accepting new patients

Locations

500 Ala Moana Blvd
Ste 1300
Honolulu, HI 96813
Phone (808) 528-3657

500 Ala Moana Blvd
Ste 1302
Honolulu, HI 96813
Phone (808) 284-3601

Interoperability endpoints

  • Direct secure messaging: mary.gutierrez@37389611368452.direct.elationemr.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758585600000",
    "number": "1306903273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 ALA MOANA BLVD STE 1300",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968134912",
            "telephone_number": "808-528-3657",
            "fax_number": "808-524-6552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 ALA MOANA BLVD STE 1300",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968134912",
            "telephone_number": "808-528-3657",
            "fax_number": "808-524-6552"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Ala Moana Blvd Ste 1-302",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968134925",
            "country_code": "US",
            "telephone_number": "808-528-3657",
            "fax_number": "808-524-6552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "MARY",
        "middle_name": "LEILANI YOSHIKO",
        "credential": "A.P.R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-02",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "APRN433",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "4513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.