Individual provider Active NPI

Edward William Gutteling, M.D.

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Hilo, HI
National Provider Identifier
1407969181
Registry record updated Nov 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X
License
MD 7826 Issued in HI
Practice address
670 Kekuanaoa St
Hilo, HI 96720-4405
Phone
(808) 961-2609
Fax
(808) 969-3728
NPI assigned
Aug 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X MD 7826 HI
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X MD 7826 HI Primary

Addresses

Primary practice location

670 Kekuanaoa St
Hilo, HI 96720-4405

Mailing address

670 Kekuanaoa St
Hilo, HI 96720-4405
Phone (808) 969-6152

Other identifiers 1

IdentifierTypeStateIssuer
073105-04MedicaidHI

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120614000245 HI Practitioner - Orthopedic Surgery 3476441494 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Hawaii John a. Burns School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

45 Mohouli St
Suite 102
Hilo, HI 96720-7210
Phone (808) 961-2609

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD 7826HIMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gutteling Enterprises, LLC Adult Reconstructive Orthopaedic Surgery CurrentSince Mar 1, 2012 Accepting new patients

Locations

45 Mohouli St
Ste 102
Hilo, HI 96720
Phone (808) 961-2609

670 Kekuanaoa St
Hilo, HI 96720
Phone (808) 961-2609

45 Mohouli St
Ste 100
Hilo, HI 96720

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DECCBD/Endpoint/DECCBD

Organizations & group practices 1

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": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1407969181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 KEKUANAOA ST",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967204405",
            "telephone_number": "808-969-6152",
            "fax_number": "808-969-3728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 KEKUANAOA ST",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967204405",
            "telephone_number": "808-961-2609",
            "fax_number": "808-969-3728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTTELING",
        "first_name": "EDWARD",
        "middle_name": "WILLIAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "HI",
            "license": "MD 7826",
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "HI",
            "license": "MD 7826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "073105-04",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilo, HI

Sources for this page

Verify at the official NPI Registry.