NPIMap

Individual provider Active NPI

John Charles Gustafson, M.D.

  • Obstetrics & Gynecology Physician
  • Ventura, CA
National Provider Identifier
1003836016
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
G36782 Issued in CA
Practice address
2795 Loma Vista Rd
Ventura, CA 93003-1544
Phone
(805) 643-8695
Fax
(805) 643-2087
NPI assigned
Jul 20, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X G36782 CA Primary

Addresses

Primary practice location

2795 Loma Vista Rd
Ventura, CA 93003-1544

Mailing address

2795 Loma Vista Rd
Ventura, CA 93003-1544
Phone (805) 643-8695

Other identifiers 8

IdentifierTypeStateIssuer
RHM08608FMedicaidCA
ZZZ82842ZMedicaidCA
RHM08609FMedicaidCA
050394OtherCABLUE CROSS
RHM18553HMedicaidCA
ZZT40394FMedicaidCA
951683892OtherCAOTHER INSURANCE
953152550OtherCAOTHER INSURANCE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050520000481 CA Practitioner - Obstetrics/Gynecology 9537106265 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Rochester School of Medicine and Dentistry, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Memorial Health SystemGroup PAC ID 9537155676, 187 clinicians

Practice addresses (Care Compare)

147 N Brent St
Ventura, CA 93003-2809
Phone (805) 652-5011

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G36782CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ventura County Obstetric and Gynecologic Medical Group, Inc Obstetrics & Gynecology CurrentSince Aug 1, 1988 Accepting new patients
Community Memorial Health System Current Accepting new patients
Community Memorial Health System CurrentSince Jan 12, 2011 Accepting new patients
Community Memorial Health System CurrentSince Jan 12, 2011 Accepting new patients
County of Ventura Past Accepting new patients

Locations

422 Arneill Rd
Ste B
Camarillo, CA 93010
Phone (805) 383-4510

852 W Ventura St
Fillmore, CA 93015
Phone (805) 524-2672

655 Ventura Ave
Oak View, CA 93022
Phone (805) 649-3750

2361 E Vineyard Ave
Oxnard, CA 93036
Phone (805) 981-3770

2921 Saviers Rd
Oxnard, CA 93033
Phone (805) 487-5588

3641 W 5th St
Oxnard, CA 93030
Phone (805) 985-5505

242 E Harvard Blvd
Ste C
Santa Paula, CA 93060
Phone (805) 525-9595

120 N Ashwood Ave
Ventura, CA 93003
Phone (805) 658-5800

138 W Main St
Ste E
Ventura, CA 93001
Phone (805) 667-2850

147 N Brent St
Ventura, CA 93003
Phone (805) 652-5011

2795 Loma Vista Rd
Ventura, CA 93003
Phone (805) 643-8695

5855 Olivas Park Dr
Ventura, CA 93003
Phone (805) 652-5469

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: jgustafson3518343@oc.providencedirect.org
  • Direct secure messaging: johngustafson@cfh.allscriptsdirect.net

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1003836016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2795 LOMA VISTA RD",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930031544",
            "telephone_number": "805-643-8695",
            "fax_number": "805-643-2087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2795 LOMA VISTA RD",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930031544",
            "telephone_number": "805-643-8695",
            "fax_number": "805-643-2087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTAFSON",
        "first_name": "JOHN",
        "middle_name": "CHARLES",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "G36782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHM08608F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ82842Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHM08609F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "050394",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHM18553H",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT40394F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER INSURANCE",
            "identifier": "951683892",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER INSURANCE",
            "identifier": "953152550",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.