Gay L Gustafson DPM PC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

252 Issued in NM

Legal business name

GAY L GUSTAFSON DPM PC

Practice address

7700 Menaul Blvd NE
Ste D
Albuquerque, NM 87110-4616

Phone

(505) 299-4487

Fax

(505) 299-4498

NPI assigned

Jan 12, 2012

Last updated

Mar 30, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gay L Gustafson, DPMNPI 1003980178

Title

Owner

Phone

(505) 299-4487

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NM2 enrollments

Enrollment records 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gay L Gustafson, DPM

  • Podiatrist
  • Albuquerque, NM
  • NPI 1003980178
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1326326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680134400000",
    "number": "1538430178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7700 MENAUL BLVD NE",
            "address_2": "STE D",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871104616",
            "telephone_number": "505-299-4487",
            "fax_number": "505-299-4498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7700 MENAUL BLVD NE",
            "address_2": "STE D",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871104616",
            "telephone_number": "505-299-4487",
            "fax_number": "505-299-4498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAY L GUSTAFSON DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-12",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A",
        "authorized_official_last_name": "GUSTAFSON",
        "authorized_official_first_name": "GAY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-299-4487",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NM",
            "license": "252",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q4698",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Camille Gavin
• Katherine J Gavin, M.D.
• Michael W Gavin, MD
• Chakri Gavva, M.D.
• Monika Gawne, CSW
• Gay Pasley Enterprises
• Louise Gaylor
• Abel Alfonso Gaytan, DDS
• Silvia Gayton
• Ana Gazashvili, LMHC

• Foot & Ankle Surgery Podiatrist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Foot & Ankle Surgery Podiatrist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.