Ian Guerrero, M.D. – Internal Medicine Physician

Key facts

NPI: 1639604341
Entity type: Individual (NPI type 1)
Primary specialty: Internal Medicine Physician 207R00000X
License: 21171 (HI)
Practice address: 91-710 Farrington Hwy Ste A120
Kapolei, HI 96707-2659
Phone: (808) 400-3899
Fax: (808) 512-2122
NPI assigned: May 1, 2017
Sex: Male
Sole proprietor: No

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.

Kapolei Primary Care Clinic Primary Care Clinic/Center · Kapolei, HI · NPI 1710726146

Medicare reassignment NPD HI

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Careresource Hawaii Home Health Agency · Honolulu, HI · NPI 1245299114

Care Compare affiliation Home health agency
Pali Momi Medical Center General Acute Care Hospital · Aiea, HI · NPI 1013961408

Care Compare affiliation Hospital
The Queens Medical Center General Acute Care Hospital · Honolulu, HI · NPI 1184612764

Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty: Internal Medicine
Education: Other, 1999
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Telehealth: Offers telehealth services

Practice addresses (Care Compare)

91-710 Farrington Hwy
Suite A120
Kapolei, HI 96707-2659
Phone (808) 400-3899

Hospital & facility affiliations

Careresource Hawaii Home health agency · Honolulu, HI · CCN 127013
The Queens Medical Center Hospital · Honolulu, HI · CCN 120001
Pali Momi Medical Center Hospital · Aiea, HI · CCN 120026

Medicare participation

Medicare fee-for-service enrollment: Enrolled in HI
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20200629003739	HI	Practitioner - Internal Medicine	8325310634	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Medicine

State licenses

License	State	Type	Specialty
21171	HI	MD	Internal Medicine Physician

Practice roles

Organization	Specialty	Status	New patients
Kapolei Primary Care Clinic		Current since Jul 23, 2024	Accepting new patients

Locations

91-710 Farrington Hwy
Ste A120
Kapolei, HI 96707
Phone (520) 982-7587

Interoperability endpoints

Direct secure messaging: ian.guerrero@792647926284292.direct.elationemr.com

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Internal Medicine Physician	207R00000X	21171	HI	Yes

Addresses

Primary practice location

91-710 Farrington Hwy Ste A120
Kapolei, HI 96707-2659

Mailing address

840 Kakala St Apt 405
Kapolei, HI 96707-4608
Phone (520) 999-0041

Other providers in Kapolei, HI

All providers in Kapolei, HI · Internal Medicine Physician in Hawaii

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 3, 2024. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
Medicare Care Compare provider data (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.