Carla Gustovich, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

L6625 Issued in TX

Practice address

13192 Dallas Pkwy Ste 620
Frisco, TX 75033-4248

Phone

(972) 668-3376

Fax

(972) 668-7546

NPI assigned

Nov 22, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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.

Enrollment records 1

Specialty

Dermatology

Education

University of Texas Medical School at Houston, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Magnolia Dermatology of Frisco PLLCGroup PAC ID 1153703731, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DJEHCD
• FHIR API: https://fhir4.healow.com/fhir/r4/DJEHCD/Endpoint/DJEHCD

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.

• Magnolia Dermatology of Frisco PLLC

  • Dermatology Physician
  • Frisco, TX
  • NPI 1821746660
  Medicare reassignment Care Compare group NPD Authorized official
• Gustovich Dermatology, PLLC

  • Dermatology Physician
  • Frisco, TX
  • NPI 1063394385
  Medicare reassignment NPD Authorized official
• Oliver Street 5.01(a) Inc.

  • Dermatology Physician
  • Dallas, TX
  • NPI 1457695413
  Medicare reassignment NPD
• Dermatology Center of Plano

  • Dermatology Physician
  • Plano, TX
  • NPI 1992868426
  NPD (past)
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Dallas, TX
  • NPI 1639808652
  NPD (past)
• Nicole Reed Medical, PLLC

  • Dermatology Physician
  • Plano, TX
  • NPI 1013155480
  NPD (past)
• North Dallas Dermatology Associates, P.a.

  • Dermatology Physician
  • Dallas, TX
  • NPI 1629188065
  NPD (past)

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1003981044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13192 DALLAS PKWY STE 620",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750334248",
            "telephone_number": "972-668-3376",
            "fax_number": "972-668-7546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13192 DALLAS PKWY STE 620",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750334248",
            "telephone_number": "972-668-3376",
            "fax_number": "972-668-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTOVICH",
        "first_name": "CARLA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-22",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "L6625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prem P Gupta, M.D.
• Shweta Gupta
• Kavita Guragain, NP
• Gus Medical Solutions LLC
• Gustovich Dermatology, PLLC
• Spencer J Guthrie, LPC
• Eliseth Gutierrez Bridon
• Chrissie Gutierrez
• Regina Gwandua
• Quincy Assoku Gyekye, CEO

• Dermatology Physician in Frisco, TX
• Providers in Frisco, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; 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.
• Medicare Care Compare (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.