Roman Wasyl Gusztak, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

110562 Issued in ZZ

Practice address

300 Longwood Avenue, Boston Children'S Hospital
Department of Anesthesiology Perioperative and Pain Med
Boston, MA 02115-5737

Phone

(617) 355-8173

Fax

(617) 730-0894

NPI assigned

Apr 24, 2013

Reactivated

May 6, 2014

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1366761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399334400000",
    "number": "1184068876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVENUE, BOSTON CHILDREN'S HOSPITAL",
            "address_2": "DEPARTMENT OF ANESTHESIOLOGY PERIOPERATIVE AND PAIN MED",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155737",
            "telephone_number": "617-355-8173",
            "fax_number": "617-730-0894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVENUE, BOSTON CHILDREN'S HOSPITAL",
            "address_2": "DEPARTMENT OF ANESTHESIOLOGY PERIOPERATIVE AND PAIN MED",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155737",
            "telephone_number": "617-355-8173",
            "fax_number": "617-730-0894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSZTAK",
        "first_name": "ROMAN",
        "middle_name": "WASYL",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-24",
        "last_updated": "2014-05-06",
        "deactivation_date": "2014-03-27",
        "reactivation_date": "2014-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "ZZ",
            "license": "110562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Gustafson, LICSW
• Empress Gustave-Fernandez
• Joseph Patrick Gustin, PMHNP-BC
• Monica Gustin, ACNPC-AG
• Joshua Gustine
• Ashleigh Kristina Guthrie, ACNP-BC
• Karen Anne Guthrie, MSW
• Rachael Faith Guthrie
• Kennet Alexander Gutierrez Artola
• Anam Oliver Gutierrez, LCSW

• Anesthesiology Physician in Boston, MA
• Providers in Boston, MA by specialty
• Anesthesiology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.