Active NPI
Troy Charles Gustafson, D.C.
- Chiropractor
- Tucson, AZ
National Provider Identifier
1881623064
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- AZ4859
- Practice address
- 5601 N Oracle Rd
Tucson, AZ 85704-3980 - Phone
- (520) 742-9395
- Fax
- (520) 742-0365
- NPI assigned
- Jul 1, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | AZ4859 | AZ | Primary |
| Chiropractor | 111N00000X | A05548 | IA |
Addresses
Primary practice location
5601 N Oracle Rd
Tucson, AZ 85704-3980
Mailing address
5601 N Oracle Rd
Tucson, AZ 85704-3980
Phone (520) 742-9395
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AZ0236370 | Other | AZ | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060817000134 | AZ | Practitioner - Chiropractic | 9133122948 | Practice locations: Tucson, AZ |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
5601 N Oracle Rd
Tucson, AZ 85704-3980
Phone (520) 742-9395
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AZ4859 | AZ | MD | Chiropractor |
| A05548 | IA | MD | Chiropractor |
| 4859 | AZ | MD | Occupational Therapist |
Interoperability endpoints
- tgustafson@abhc0001.direct.chirotouch.md
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151712000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1341446400000",
"number": "1881623064",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5601 N ORACLE RD",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857043980",
"telephone_number": "520-742-9395",
"fax_number": "520-742-0365"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5601 N ORACLE RD",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857043980",
"telephone_number": "520-742-9395",
"fax_number": "520-742-0365"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUSTAFSON",
"first_name": "TROY",
"middle_name": "CHARLES",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-01",
"last_updated": "2012-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "AZ",
"license": "AZ4859",
"primary": true
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IA",
"license": "A05548",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "AZ0236370",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.