Kurt Gustavson, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

99 Issued in MT

Practice address

6216 Whisper LN SW
Lakewood, WA 98499-1139

Phone

(253) 968-1613

NPI assigned

Apr 20, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

William M. Scholl College of Podiatric Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

U S Health Dept of Health and Human ServicesGroup PAC ID 9638081623, 98 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• P H S Indian Hospital at Browning - Blackfeet Hospital, Browning, MT, CCN 270074

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• US Health Dept of Health & Human Services

  • Rural Health Clinic/Center
  • Poplar, MT
  • NPI 1972694602

  TX

  Medicare reassignment Care Compare group NPD
• U S Health Dept of Health & Human Services

  • Critical Access Hospital
  • Lodge Grass, MT
  • NPI 1750410395
  NPD
• U S Health Dept of Health & Human Services

  • General Acute Care Hospital
  • Browning, MT
  • NPI 1861409955
  NPD
• U S Health Dept of Health & Human Services

  • Clinic/Center
  • Heart Butte, MT
  • NPI 1598867848
  NPD (past)

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225255086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6216 WHISPER LN SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984991139",
            "telephone_number": "253-968-1613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6216 WHISPER LN SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984991139",
            "telephone_number": "253-968-1613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTAVSON",
        "first_name": "KURT",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MT",
            "license": "99",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "99",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Makiko Guji
• Melanie A Gulish, MSPT
• Sonia Gupta
• Sheri L Gurth, AA
• Asurupi Gurung, FNP
• Kelly Ann Gutierrez, PHD
• Ryan Gutierrez, BSW
• Teresa Gutierrez, P.T.
• Sara Jane Guy
• Krista Elizabeth Guyll, PA-C

• Podiatrist in Lakewood, WA
• Providers in Lakewood, WA by specialty
• Podiatrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.