Individual provider Active NPI

John Gustaitis, M.D.

  • Diagnostic Radiology Physician
  • Munster, IN
National Provider Identifier
1265425599
Registry record updated Mar 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
01023010A Issued in IN
Practice address
901 Macarthur Blvd
Munster Radiology Group
Munster, IN 46321-2901
Phone
(219) 836-4569
NPI assigned
Aug 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 01023010A IN Primary
Nuclear Radiology Physician 2085N0904X 01023010A IN

Addresses

Primary practice location

901 Macarthur Blvd
Munster Radiology Group
Munster, IN 46321-2901

Mailing address

9201 Calumet Ave
Munster, IN 46321-2807
Phone (219) 836-2022

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20100708000464 IN Practitioner - Diagnostic Radiology 5496732414 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Northwestern University Feinberg Medical School, 1967
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Munster Radiology Group PCGroup PAC ID 1951299940, 26 clinicians
Powers Health Diagnostic Group LLCGroup PAC ID 8820573280, 25 clinicians

Practice addresses (Care Compare)

10020 Don S Powers Dr
Munster, IN 46321-4054
Phone (219) 836-4599

10215 Broadway
Crown Point, IN 46307-8001
Phone (219) 703-4550

1500 S Lake Park Ave
Hobart, IN 46342-6638
Phone (219) 942-0551

1545 W US Hwy 30
Schererville, IN 46375-1562
Phone (219) 836-3477

3545 Arbor Blvd
Portage, IN 46368-4298
Phone (219) 947-6729

3800 Saint Mary Rd
Valparaiso, IN 46383-3986
Phone (219) 286-3700

4321 Fir St
East Chicago, IN 46312-3049
Phone (219) 392-1700

505 W US Hwy 30
Schererville, IN 46375-2650
Phone (219) 322-3311

7651 Harvest Dr
Schererville, IN 46375-3476
Phone (219) 322-5723

901 Macarthur Blvd
Munster, IN 46321-2901
Phone (219) 836-1600

9660 Wicker Ave
Saint John, IN 46373-9487
Phone (219) 365-1166

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01023010AINMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Munster Radiology Group PC Nuclear Radiology CurrentSince Jul 1, 2002 Accepting new patients
Nephrology Specialists, PC. Past Accepting new patients

Locations

4321 Fir St
East Chicago, IN 46312
Phone (219) 392-1700

901 MacArthur Blvd
Munster, IN 46321
Phone (219) 703-1443

10010 Calumet Ave
Munster, IN 46321

9201 Calumet Ave
Munster, IN 46321
Phone (219) 836-9024

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 and National Provider Directory roles.

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": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205798400000",
    "number": "1265425599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9201 CALUMET AVE",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212807",
            "telephone_number": "219-836-2022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 MACARTHUR BLVD",
            "address_2": "MUNSTER RADIOLOGY GROUP",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212901",
            "telephone_number": "219-836-4569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTAITIS",
        "first_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2008-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "01023010A",
            "primary": true
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "IN",
            "license": "01023010A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

Verify at the official NPI Registry.