Advanced Practice Nurse (Nurse Practitioner) - Gastroenterology

Local GI market

50 gastroenterologists

within 30 miles. That is 14.6 per 100,000 adults aged 45-74, close to the US average (13.6).

36% of them finished medical school 30 or more years ago (US: 36%).

Source: CMS Doctors and Clinicians file; Census ACS 2019-2023.

Procedure mix nearby

73% colonoscopy

Medicare fee-for-service procedures billed within 30 miles in 2024: 9,155 colonoscopies, 3,180 EGDs, 92 ERCPs, 56 EUS.

ERCP volume is thin and EUS is thin for the population, compared with the US (adjusted for Medicare Advantage share). 100% done in a hospital or surgery center; 55% by gastroenterologists.

63.3% of adults 45-75 in this county are up to date on colorectal screening, about the same as the state (62.6%).

55% of Medicare patients here are in Medicare Advantage (state: 53%). Medicare procedure counts above cover only the other 45%.

Source: CMS Medicare Physician and Other Practitioners by provider and service, 2024 (fee-for-service only; services for fewer than 11 patients hidden). CMS MA penetration; CDC PLACES 2025 (2022 survey).

Cost of living

Prices in Hawaii are 10% above the US average.

$168k here buys what $152k buys in an average-priced state

Hawaii state income tax on $168k: about $12k (7%), single filer, before deductions. Local taxes not included.

Source: BEA regional price parities, 2024. State level; big metros cost more. Tax: Tax Foundation 2026 state brackets.

Hospitals and surgery centers

9 hospitals, 15 surgery centers

within 30 miles. 8 of the hospitals run an emergency department; 5 of 6 rated hold 4 or 5 CMS stars.

Nearest: The Queens Medical Center (1 mi, 3 stars); Straub Clinic and Hospital (1 mi, 4 stars); Kaiser Foundation Hospital (2 mi, 4 stars).

7 of the surgery centers reported 5,954 Medicare outpatient colonoscopies in a year. More endoscopy centers usually means more ASC ownership and partnership options.

Source: CMS Care Compare, Hospital General Information and ASC Quality Reporting (ASC-12 colonoscopy cases, Medicare fee-for-service). Located by ZIP code.

State rules for your contract

Noncompete: Courts decide

No physician-specific statute. Courts decide case by case whether the time, distance and scope are reasonable.

Interstate Medical Licensure Compact: issues compact licenses, cannot be your home state.

State law summary, not legal advice. Have a contract lawyer read your agreement. IMLC states; all states.

Employer

Federal (VA), Government

The employer is a government employer. W-2 jobs with it usually count toward Public Service Loan Forgiveness (PSLF). Confirm which entity pays you.

Source

Visas (H-1B / J-1)

This employer filed 4 H-1B wage filings for attending GI physicians (2024), at $337k-$384k (median $361k).

All GI H-1B filings in Hawaii: 1, median $491k.

Parts of this county are federal primary care shortage areas (HPSAs). Check the exact practice address. Conrad 30 J-1 waiver jobs usually must be in a shortage area; each state sets its own rules. State J-1 waiver contacts (3RNET).

Source: US Dept. of Labor LCA disclosure data (certified H-1B, FY2024-FY2026); HRSA HPSA data. All GI H-1B employers