NPIMap

Organization Active NPI

Hilo Urgent Care Center, LLC

  • Urgent Care Clinic/Center
  • Hilo, HI
National Provider Identifier
1487750089
Registry record updated Nov 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
HILO URGENT CARE CENTER, LLC
Practice address
670 Kekuanaoa St
Hilo, HI 96720-4405
Phone
(808) 969-3051
Fax
(808) 934-0153
NPI assigned
Sep 15, 2006
Last updated
Nov 6, 2020By the provider in NPPES
Organization subpart
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

Authorized official

Name
Dr. Edward W. Gutteling, M.D.NPI 1407969181
Title
Owner
Phone
(808) 969-3051

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

670 Kekuanaoa St
Hilo, HI 96720-4405

Mailing address

670 Kekuanaoa St
Hilo, HI 96720-4405
Phone (808) 969-3051

Other identifiers 1

IdentifierTypeStateIssuer
55465OtherHIGROUP PIN NUMBER

Other names 1

  • HILO URGENT CARE CENTER Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040310000188 HI Part B Supplier - Clinic/Group Practice 7214825231 Receives reassigned benefits from 14 practitioners
Practice locations: Kea'Au, HI; Hilo, HI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
12D1000215Hilo Urgent Care Center670 Kekuanaoa Street, Hilo, HI 96720Certificate of waiverJun 4, 2028

National Provider Directory

National Provider Directory

Locations

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

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604620800000",
    "number": "1487750089",
    "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": "808-969-3051",
            "fax_number": "808-934-0153"
        },
        {
            "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": "808-969-3051",
            "fax_number": "808-934-0153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HILO URGENT CARE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A",
        "authorized_official_last_name": "GUTTELING",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-969-3051",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PIN NUMBER",
            "identifier": "55465",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HILO URGENT CARE CENTER",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Hilo, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.