Individual provider Active NPI

Tracey Lynn Gustitus, CRNP

  • Gerontology Clinical Nurse Specialist
  • West Reading, PA
National Provider Identifier
1164935391
Registry record updated Jun 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Clinical Nurse SpecialistTaxonomy code 364SG0600X
License
SP017797 Issued in PA
Practice address
420 S 5TH Ave
West Reading, PA 19611-2143
Phone
(484) 628-5455
NPI assigned
Nov 9, 2017
Last updated
Jun 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Clinical Nurse Specialist 364SG0600X SP017797 PA Primary

Addresses

Primary practice location

420 S 5TH Ave
West Reading, PA 19611-2143

Mailing address

PO Box 13579
Reading, PA 19612-3579
Phone (484) 628-0799

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180109001565 PA Practitioner - Nurse Practitioner 2163781600 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tower Health Medical GroupGroup PAC ID 7618889213, 578 clinicians

Practice addresses (Care Compare)

2610 Keiser Blvd
Wyomissing, PA 19610-3333
Phone (484) 750-3950

420 S 5TH Ave
West Reading, PA 19611-2143

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.71 of 100Reported as group
Quality
73.34
Promoting interoperability
97
Improvement activities
40
Cost
78.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP017797PAMDGerontology Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Tower Health Medical Group Current Accepting new patients
Tower Health Medical Group CurrentSince Jan 8, 2018 Accepting new patients
Tower Health Medical Group CurrentSince Jan 8, 2018 Accepting new patients

Locations

301 S 7th Ave
Ste 130
West Reading, PA 19611
Phone (610) 988-4630

420 S 5th Ave
West Reading, PA 19611
Phone (484) 628-3637

2610 Keiser Blvd
Wyomissing, PA 19610
Phone (484) 628-9127

Organizations & group practices 3

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 6

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": "1510185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1164935391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13579",
            "city": "READING",
            "state": "PA",
            "postal_code": "196123579",
            "telephone_number": "484-628-0799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 S 5TH AVE",
            "city": "WEST READING",
            "state": "PA",
            "postal_code": "196112143",
            "telephone_number": "484-628-5455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTITUS",
        "first_name": "TRACEY",
        "middle_name": "LYNN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-09",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SG0600X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Gerontology",
            "state": "PA",
            "license": "SP017797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Reading, PA

Sources for this page

Verify at the official NPI Registry.