Mary Katherine Warren, M.D.

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

9630 Issued in HI

Practice address

75-5995 Kuakini Hwy
Suite 211
Kailua Kona, HI 96740-2144

Phone

(808) 329-2500

Fax

(808) 334-1808

NPI assigned

Feb 13, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Mary Katherine Robinson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 1, 2024 through Jul 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Mary K R Warren M.D. Inc

  • Primary Care Clinic/Center
  • Kailua Kona, HI
  • NPI 1306093968
  NPD (past) Authorized official

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962544122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75-5995 KUAKINI HWY",
            "address_2": "SUITE 211",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967402144",
            "telephone_number": "808-329-2500",
            "fax_number": "808-334-1808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75-5995 KUAKINI HWY",
            "address_2": "SUITE 211",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967402144",
            "telephone_number": "808-329-2500",
            "fax_number": "808-334-1808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARREN",
        "first_name": "MARY",
        "middle_name": "KATHERINE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "HI",
            "license": "9630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMAA",
            "identifier": "A84303",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "208157",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHA",
            "identifier": "55478951",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "ROBINSON",
            "middle_name": "KATHERINE",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sophia J Wang, PHD
• Theresa Ihsin Wang, M.D.
• Walter J Wang, MD
• Cristina Maria Ward
• Michael Warnecke, BSN, RN
• Jamal Fulani Wasan, PH.D
• Michaela Watts, ND
• Richard Robert Watts, ATC
• Krista Anne Weber, CRNA
• David Weiner, LCSW

• Adult Medicine Physician in Kailua Kona, HI
• Providers in Kailua Kona, HI by specialty
• Adult Medicine Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.