Gary J Gustafson, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

17551 Issued in NE

Practice address

8303 Dodge St
Omaha, NE 68114-4108

Phone

(402) 354-4424

Fax

(402) 354-4435

NPI assigned

Aug 21, 2006

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 3

Medicare fee-for-service enrollment

Enrolled in NE, ND, IA3 enrollments

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 3

Specialty

Emergency Medicine

Education

University of Nebraska College of Medicine, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Seven Hills Emergency Group PCGroup PAC ID 1456760644, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Greene County Medical Center Hospital, Jefferson, IA, CCN 161325

Merit-based Incentive Payment System (MIPS)

Final score

88.5 of 100Reported as group

Quality

79.54

Improvement activities

40

Cost

78.56

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ggustafson1152876@direct.unitypoint.org

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.

• Seven Hills Emergency Group, PC

  • Emergency Medicine Physician
  • Jefferson, IA
  • NPI 1467030254
  Medicare reassignment Care Compare group NPD
• Jennie M Melham Memorial Medical Center Inc

  • Certified Registered Nurse Anesthetist
  • Broken Bow, NE
  • NPI 1366659773
  Medicare reassignment NPD
• Jennie M Melham Memorial Medical Center Inc

  • Critical Access Hospital
  • Broken Bow, NE
  • NPI 1538232244
  Medicare reassignment NPD
• Healthsource Partners ND LLC

  • Emergency Medicine Physician
  • Bismarck, ND
  • NPI 1235619545
  Medicare reassignment NPD
• St Luke's Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD

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

• Greene County Medical Center

  • Critical Access Hospital
  • Jefferson, IA
  • NPI 1083654883
  Care Compare affiliation

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399593600000",
    "number": "1881700326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2797",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681032797",
            "telephone_number": "402-354-4230",
            "fax_number": "402-354-6171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8303 DODGE ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681144108",
            "telephone_number": "402-354-4424",
            "fax_number": "402-354-4435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTAFSON",
        "first_name": "GARY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2014-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NE",
            "license": "17551",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1133678",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47037660412",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1881700326",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tricia Gushard
• Rachel A Gusse, PT
• Angela A Gustafson Chase
• Audrey C Gustafson, PA-C
• Corey Gustafson
• Jordan Gustafson
• Karen M Gustafson, LMHP
• Ariel Gustavson
• Jodi Lynn Gustin, OTR/L
• Lisa Gustin

• Emergency Medicine Physician in Omaha, NE
• Providers in Omaha, NE by specialty
• Emergency Medicine Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2014; 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.
• 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.

Verify at the official NPI Registry.