Eric Leif Gustafson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

T3627 Issued in TX

Practice address

3924 Drexmore Rd
Fort Worth, TX 76244-8510

Phone

(936) 933-9583

NPI assigned

Apr 11, 2018

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 TX

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

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/AAIAAA
• Direct secure messaging: egustafson45056@direct.phhs.org
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• FHIR API: https://fhir-usa.unify.chbase.com/org/conc-1a231bb4

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.

• Altus Exceptional Physician Group PLLC

  • Emergency Medicine Physician
  • Orange, TX
  • NPI 1730869207
  Medicare reassignment NPD
• Ballinger Memorial Hospital District

  • Critical Access Hospital
  • Ballinger, TX
  • NPI 1225038938
  Medicare reassignment NPD
• Baylor County Hospital District

  • Critical Access Hospital
  • Seymour, TX
  • NPI 1194893263
  Medicare reassignment NPD
• Castro County Hospital District

  • Critical Access Hospital
  • Dimmitt, TX
  • NPI 1033118716
  Medicare reassignment NPD
• Concho County Hospital District

  • Family Medicine Physician
  • Eden, TX
  • NPI 1134166226
  Medicare reassignment NPD
• Concord Medical Group of Texas PLLC

  • Emergency Medicine Physician
  • Lubbock, TX
  • NPI 1750790762
  Medicare reassignment NPD
• Concord Medical Group PLLC

  • Emergency Medicine Physician
  • Lubbock, TX
  • NPI 1083630610
  Medicare reassignment NPD
• County of Yoakum

  • Critical Access Hospital
  • Denver City, TX
  • NPI 1790702371
  Medicare reassignment NPD
• Fisher County Hospital District

  • Rural Health Clinic/Center
  • Rotan, TX
  • NPI 1104808112
  Medicare reassignment NPD
• Fisher County Hospital District

  • Critical Access Hospital
  • Rotan, TX
  • NPI 1598746703
  Medicare reassignment NPD
• Hemphill County Hospital District

  • Rural Health Clinic/Center
  • Canadian, TX
  • NPI 1720404924
  Medicare reassignment NPD
• Moore County Hospital District

  • Critical Access Hospital
  • Dumas, TX
  • NPI 1700991700

  Family Medicine

  Medicare reassignment NPD

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

{
    "created_epoch": "1523404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714694400000",
    "number": "1689171035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3924 DREXMORE RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762448510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3924 DREXMORE RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762448510",
            "telephone_number": "936-933-9583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTAFSON",
        "first_name": "ERIC",
        "middle_name": "LEIF",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-11",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "T3627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monjit S Guram, DDS
• Kara C Gurley, MA
• Nicholas Troy Gurney, MD
• Gurpreet S. Bajaj, M.D., P.a.
• Marcos Gushue
• Robert A Gustafson, LCSW
• Karen Gustafsson, LVN
• Heidi Gustus
• Kirbi Guthman, RN
• Cara Guthrie-Chu, DNP, APRN, AGACNP-BC

• Family Medicine Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2024; 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.