Paul Gustafson, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

41092 Issued in MA

Practice address

398 Neponset Ave
Dorchester, MA 02122-3134

Phone

(617) 282-3200

Fax

(617) 282-8201

NPI assigned

Dec 13, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359936000000",
    "number": "1811972797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 MORTON ST",
            "city": "MATTAPAN",
            "state": "MA",
            "postal_code": "021262834",
            "telephone_number": "617-533-2300",
            "fax_number": "617-282-8201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "398 NEPONSET AVE",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021223134",
            "telephone_number": "617-282-3200",
            "fax_number": "617-282-8201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTAFSON",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-13",
        "last_updated": "2013-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "41092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2052792",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grounded Mama
• Kara Mary Guittarr, RN
• Lindsay Guittarr, RN
• Tania Guity
• Padma Gulur, MD
• Betty Gustave, RN
• Christian Guzman
• Mo Ha
• Sarah Hagedorn
• Jordan Haghighi

• Pediatrics Physician in Dorchester, MA
• Providers in Dorchester, MA by specialty
• Pediatrics Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.