Individual provider Active NPI

Karen L Gutierrez, FNP

  • Family Nurse Practitioner
  • Williamsville, NY
National Provider Identifier
1659365500
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
331702 Issued in NY
Practice address
192 Park Club LN
Williamsville, NY 14221-5270
Phone
(716) 422-0010
Fax
(716) 422-0618
NPI assigned
Sep 7, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 331702 NY Primary

Addresses

Primary practice location

192 Park Club LN
Williamsville, NY 14221-5270

Mailing address

908 Niagara Falls Blvd Ste 208
North Tonawanda, NY 14120-2019
Phone (716) 692-3302

Other identifiers 1

IdentifierTypeStateIssuer
02346454MedicaidNY

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
I20210128002032 HI Practitioner - Nurse Practitioner 5890810790 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.39 of 100Reported as group
Quality
79.9
Promoting interoperability
99
Improvement activities
40
Cost
82.23

Merit-based Incentive Payment System (MIPS)

Final score
70.96 of 100Reported as group
Quality
47.2
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kauai Medical Clinic CurrentSince Jan 11, 2021 Accepting new patients
Kauai Medical Clinic CurrentSince Jan 11, 2021 Accepting new patients

Locations

3-3420 Kuhio Hwy
Ste B
Lihue, HI 96766
Phone (808) 245-1500

3-3420 Kuhio Hwy
Ste B
Lihue, HI 96766
Phone (808) 245-1500

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": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1659365500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 NIAGARA FALLS BLVD STE 208",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "141202019",
            "telephone_number": "716-692-3302",
            "fax_number": "716-692-4342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "192 PARK CLUB LN",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215270",
            "telephone_number": "716-422-0010",
            "fax_number": "716-422-0618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "KAREN",
        "middle_name": "L",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-07",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "331702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02346454",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.