Individual provider Active NPI

Crystal M Gustin, O.D.

  • Optometrist
  • Lafayette, LA
National Provider Identifier
1073891024
Registry record updated Jul 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1618-651T Issued in LA
Practice address
5725 Johnston St Ste 2314
Lafayette, LA 70503-5315
Phone
(337) 984-2140
Fax
(337) 984-2416
NPI assigned
Jul 25, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1618-651T LA Primary

Addresses

Primary practice location

5725 Johnston St Ste 2314
Lafayette, LA 70503-5315

Mailing address

5725 Johnston St Ste 2314
Lafayette, LA 70503-5315
Phone (337) 984-2140

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110926000187 LA Practitioner - Optometry 8527239466 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Today'S Eyecare, LLCGroup PAC ID 6608865548, 4 clinicians

Practice addresses (Care Compare)

214 Southcity Pkwy
Suite 103
Lafayette, LA 70503-5718
Phone (337) 313-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1618-651TLAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Today'S Eyecare, LLC Optometrist CurrentSince Aug 1, 2011 Accepting new patients
Capital Eyes LLC Optometrist Past Accepting new patients

Locations

214 Southcity Pkwy
Ste 103
Lafayette, LA 70503
Phone (337) 313-2020

5725 Johnston St
Ste 2314
Lafayette, LA 70503
Phone (337) 984-2410

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": "1311552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467763200000",
    "number": "1073891024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5725 JOHNSTON ST STE 2314",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705035315",
            "telephone_number": "337-984-2140",
            "fax_number": "337-984-2416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5725 JOHNSTON ST STE 2314",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705035315",
            "telephone_number": "337-984-2140",
            "fax_number": "337-984-2416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTIN",
        "first_name": "CRYSTAL",
        "middle_name": "M",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-25",
        "last_updated": "2016-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "LA",
            "license": "1618-651T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.