NPIMap

Individual provider Active NPI

George C Gustafson, M.D.

  • Cardiovascular Disease Physician
  • Colorado Springs, CO
National Provider Identifier
1689669483
Registry record updated Jun 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
43485 Issued in CO
Practice address
1400 E Boulder St
Ste 700
Colorado Springs, CO 80909-5533
Phone
(719) 635-7172
Fax
(719) 444-3759
NPI assigned
Sep 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 43485 CO Primary

Addresses

Primary practice location

1400 E Boulder St
Ste 700
Colorado Springs, CO 80909-5533

Mailing address

1400 E Boulder St
Ste 700
Colorado Springs, CO 80909-5533
Phone (719) 365-9950

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050809000062 CO Practitioner - Cardiovascular Disease (Cardiology) 7618864950 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
R Franklin University of Med & Sci/Chicago Medical School, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

1400 E Boulder St
Suite 700 Uchmg Cardio/Cardiac Surg Col
Colorado Springs, CO 80909-5533
Phone (719) 635-7172

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43485COMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Sep 29, 2013 Accepting new patients
Uropartners, LLC Past Accepting new patients
Southwest Cardiovascular Consultants,SC Cardiovascular Disease Past Accepting new patients
Orthopedic Associates of Peoria, S.C. Past Accepting new patients
Memorial Health System Internal Medicine Past Accepting new patients
Uch-MHS Past Accepting new patients
Heart Care Centers of Illinois, SC Internal Medicine Past Accepting new patients

Locations

286 16th St
Burlington, CO 80807
Phone (719) 346-5311

1335 Phay Ave
Ste D
Canon City, CO 81212
Phone (719) 269-8820

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

525 Bob Peters Grv
#309
Colorado Springs, CO 80909
Phone (719) 475-2794

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

1380 E Fillmore St
Ste 100
Colorado Springs, CO 80907
Phone (719) 630-1006

1400 E Boulder St
Colorado Springs, CO 80909
Phone (719) 365-5120

1400 E Boulder St
Ste 700
Colorado Springs, CO 80909
Phone (719) 365-7172

525 Bob Peters Grv
Ste 309
Colorado Springs, CO 80909
Phone (719) 365-6464

9320 Grand Cordera Pkwy
Ste 100
Colorado Springs, CO 80924
Phone (719) 282-6337

501 W 5th St
Florence, CO 81226
Phone (719) 784-4816

201 Kendall Dr
Lamar, CO 81052
Phone (719) 336-0261

301 Kendall Dr
Lamar, CO 81052
Phone (719) 336-3179

2221 Wellness Way
Lamar, CO 81052
Phone (719) 336-0261

403 Kendall Dr
Lamar, CO 81052
Phone (719) 336-6767

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

373 E 10th Ave
Springfield, CO 81073
Phone (719) 523-4501

900 Church St
Springfield, CO 81073
Phone (719) 523-6221

Organizations & group practices 8

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 25

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1127001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1689669483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E BOULDER ST",
            "address_2": "STE 700",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809095533",
            "telephone_number": "719-365-9950",
            "fax_number": "719-365-9969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E BOULDER ST",
            "address_2": "STE 700",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809095533",
            "telephone_number": "719-635-7172",
            "fax_number": "719-444-3759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTAFSON",
        "first_name": "GEORGE",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-18",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CO",
            "license": "43485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.