Gustavel Orthopedics PLLC

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

Legal business name

GUSTAVEL ORTHOPEDICS PLLC

Practice address

1702 W Fairview Ave
Boise, ID 83702-5121

Phone

(208) 957-7400

NPI assigned

Nov 20, 2018

Organization subpart

No

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

Authorized official

Name

Cindy Young

Title

Manager

Phone

(208) 957-7400

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CHDGBD

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sabrina Dlouhy, PA-C

  • Physician Assistant
  • Meridian, ID
  • NPI 1457751802
  NPD (past)
• Meghan M Galloway, P.A.

  • Physician Assistant
  • Boise, ID
  • NPI 1679726434
  NPD (past)
• Michael J Gustavel, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Boise, ID
  • NPI 1306842182
  NPD (past)
• Maryann Ozier, P.A.

  • Physician Assistant
  • Boise, ID
  • NPI 1811002900
  NPD (past)
• Anntara Smith, PA-C

  • Physician Assistant
  • Boise, ID
  • NPI 1659309557
  NPD (past)
• Amy S Waselchuk, P.A.

  • Physician Assistant
  • Boise, ID
  • NPI 1033129465
  NPD (past)

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

{
    "created_epoch": "1542672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551312000000",
    "number": "1861961732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 W FAIRVIEW AVE",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837025121",
            "telephone_number": "208-957-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1702 W FAIRVIEW AVE",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837025121",
            "telephone_number": "208-957-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUSTAVEL ORTHOPEDICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-20",
        "last_updated": "2019-02-28",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "208-957-7400"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Animesh Gupta
• Pranati Pravin Gupte
• Michael L Gurr, RT
• Brandi Gustafson, DPT
• Jill Reena Gustafson, CNM
• Michael J Gustavel, MD
• Terry L Gustavel, D.D.S.
• Evan Gustavsen, PT, DPT
• Jill Guth, BA
• Brittany Guthrie, PA-C

• Sports Medicine (Orthopaedic Surgery) Physician in Boise, ID
• Providers in Boise, ID by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2019; 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.