Individual provider Active NPI

Gina Wilson

  • Emergency Medicine Physician
  • Honolulu, HI
National Provider Identifier
1457713646
Registry record updated Sep 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
20278 Issued in HI
Practice address
770 Kapiolani Blvd Ste 705
Honolulu, HI 96813-5241
Phone
(808) 597-8799
NPI assigned
Mar 25, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 20278 HI Primary

Addresses

Primary practice location

770 Kapiolani Blvd Ste 705
Honolulu, HI 96813-5241

Mailing address

770 Kapiolani Blvd Ste 705
Honolulu, HI 96813-5241

Other practice location 1

901 Rancho Ln Ste 135
Las Vegas, NV 89106-3826
Phone (702) 383-7885

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI, CA, WI, FL, OH, PA, NY, NJ, WA, TX, VA, GA, MA, MN, IL, MI, MO, DC, DE, CO, WY21 enrollments
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 21

Enrollment IDStateProvider typePAC IDDetails
I20190809000819 HI Practitioner - Emergency Medicine 5395031462 Reassigns benefits to 5 organizations
I20240222001421 CA Practitioner - Emergency Medicine 5395031462 Reassigns benefits to 1 organization
I20241030002985 WI Practitioner - Emergency Medicine 5395031462 Reassigns benefits to 1 organization
I20241031004231 FL Practitioner - Emergency Medicine 5395031462
I20241104003071 OH Practitioner - Emergency Medicine 5395031462
I20241104003928 PA Practitioner - Emergency Medicine 5395031462
I20241106002203 NY Practitioner - Emergency Medicine 5395031462
I20241108000436 NJ Practitioner - Emergency Medicine 5395031462
I20241108000575 WA Practitioner - Emergency Medicine 5395031462 Reassigns benefits to 1 organization
I20241111002772 TX Practitioner - Emergency Medicine 5395031462
I20241112000940 VA Practitioner - Emergency Medicine 5395031462 Reassigns benefits to 1 organization
I20241113001359 GA Practitioner - Emergency Medicine 5395031462 Reassigns benefits to 1 organization
I20241115002604 MA Practitioner - Emergency Medicine 5395031462 Reassigns benefits to 1 organization
I20241204001205 MN Practitioner - Emergency Medicine 5395031462 Reassigns benefits to 1 organization
I20241204002414 IL Practitioner - Emergency Medicine 5395031462 Reassigns benefits to 1 organization
I20241205003895 MI Practitioner - Emergency Medicine 5395031462
I20241206001411 MO Practitioner - Emergency Medicine 5395031462 Reassigns benefits to 1 organization
I20241213003698 DC Practitioner - Emergency Medicine 5395031462 Reassigns benefits to 1 organization
I20250116000128 DE Practitioner - Emergency Medicine 5395031462
I20250312002135 CO Practitioner - Emergency Medicine 5395031462 Reassigns benefits to 1 organization
I20250320003813 WY Practitioner - Emergency Medicine 5395031462 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Tufts University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Geniemd Medical Group Mo PCGroup PAC ID 5193190072, 24 clinicians
The Emergency Group, Inc.Group PAC ID 1355244542, 49 clinicians

Practice addresses (Care Compare)

1111 Broadway
Suite 300
Oakland, CA 94607-4167
Phone (925) 460-9191

1301 Punchbowl St
Honolulu, HI 96813-2402
Phone (808) 597-8778

Hospital & facility affiliations

  • The Queens Medical Center Hospital, Honolulu, HI, CCN 120001

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20278HIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Relymd Virtual Health Ca, PC Emergency Medicine CurrentSince Oct 1, 2025 Accepting new patients
Geniemd Medical Group, Mo, P.C. CurrentSince Jan 9, 2024 Accepting new patients
Relymd Virtual Health Regional, PC Emergency Medicine CurrentSince Aug 15, 2025 Accepting new patients
The Emergency Group, Inc. Emergency Medicine CurrentSince Aug 1, 2019 Accepting new patients
Relymd Virtual Health Ga, LLC Emergency Medicine CurrentSince May 10, 2025 Accepting new patients
Relymd Virtual Health TX, PA Emergency Medicine CurrentSince Nov 19, 2025 Accepting new patients

Locations

1111 Broadway
Ste 300
Oakland, CA 94607
Phone (281) 948-8014

6612 Owens Dr
Pleasanton, CA 94588
Phone (928) 460-9191

5665 New Northside Dr
Ste 320
Sandy Springs, GA 30328
Phone (770) 874-5468

770 Kapiolani Blvd
Ste 705
Honolulu, HI 96813
Phone (808) 597-8778

1301 Punchbowl St
Honolulu, HI 96813
Phone (808) 538-9011

Organizations & group practices 7

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": "1458864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568678400000",
    "number": "1457713646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 KAPIOLANI BLVD STE 705",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968135241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 KAPIOLANI BLVD STE 705",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968135241",
            "telephone_number": "808-597-8799"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 Rancho Ln Ste 135",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891063826",
            "country_code": "US",
            "telephone_number": "702-383-7885",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "GINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-25",
        "last_updated": "2019-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "HI",
            "license": "20278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.