Jon Andrew Gustafson

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

OT025098 Issued in PA

Practice address

35 Justin Dr FL 4
Danville, PA 17821-7951

Phone

(570) 271-6164

Fax

(570) 271-6141

NPI assigned

Mar 25, 2026

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 PA

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1774396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785542400000",
    "number": "1629917620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178229800",
            "telephone_number": "570-271-6164",
            "fax_number": "570-271-6141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 JUSTIN DR FL 4",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178217951",
            "telephone_number": "570-271-6164",
            "fax_number": "570-271-6141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTAFSON",
        "first_name": "JON",
        "middle_name": "ANDREW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-03-25",
        "last_updated": "2026-08-01",
        "certification_date": "2026-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OT025098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rajeev Gupta, MBBS
• Marianne T. Gursky, CRNP
• Alexandra Chironna Guse, PA-C
• Bryan William Gushen, PHARMD
• Megan M. Gusick, CRNP
• Dale K. Gustitus, CRNP
• Savannah Guyot
• Kelly S Guza, PHARM.D.
• Ngoc-Tram Ha, M.D.
• Michael Haak, MD

• Internal Medicine Physician in Danville, PA
• Providers in Danville, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.