Geoffrey Peter Gustavsen, M.D.

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

C10007058 Issued in DE

Practice address

282 The GRN
Newark, DE 19716-0009

Phone

(302) 831-2227

Fax

(302) 831-6407

NPI assigned

Jan 25, 2006

Last updated

Jan 26, 2016By the provider in NPPES

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

Enrolled in DE

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

Specialty

Family Practice

Education

University of Washington School of Medicine, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Newark Emergency CenterGroup PAC ID 9931620291, 30 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Newark Emergency Center

  • Emergency Medicine Physician
  • Newark, DE
  • NPI 1700864576
  Medicare reassignment Care Compare group NPD
• VHS Outpatient Clinics, Inc.

  dba Abrazo Medical Group

  • Multi-Specialty Clinic/Center
  • Goodyear, AZ
  • NPI 1912979964
  NPD (past)

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453766400000",
    "number": "1396715959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "282 THE GRN",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197160009",
            "telephone_number": "302-831-2227",
            "fax_number": "302-831-6407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "282 THE GRN",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197160009",
            "telephone_number": "302-831-2227",
            "fax_number": "302-831-6407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTAVSEN",
        "first_name": "GEOFFREY",
        "middle_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2016-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "DE",
            "license": "C10007058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maya Gupta, M.D.
• Monika Gupta, M.D.
• Saurabh Gupta, MD
• Shivali Gupta
• Blake Gustafson, MD
• Amanda Guth, DO, MPH
• Jeffrey W Gutting, PA
• Carole A Guy, M.D.
• Stacie Guyton, NP
• Diana Paola Guzman

• Sports Medicine (Family Medicine) Physician in Newark, DE
• Providers in Newark, DE by specialty
• Sports Medicine (Family Medicine) Physician in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2016; 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.