Carl a Gustafson, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

MA2132 Issued in MA

Legal business name

CARL A GUSTAFSON, O.D.

Practice address

649 Broad St
Weymouth, MA 02189-2041

Phone

(781) 335-1166

NPI assigned

Mar 26, 2010

Last updated

Mar 26, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Carl Gustafson

Title

Owner

Phone

(781) 335-1166

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Cari Cannon, O.D.

  • Optometrist
  • West Roxbury, MA
  • NPI 1891802435
  NPD (past)

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

{
    "created_epoch": "1269561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269561600000",
    "number": "1902120470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "649 BROAD ST",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021892041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "649 BROAD ST",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021892041",
            "telephone_number": "781-335-1166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARL A GUSTAFSON, O.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-26",
        "last_updated": "2010-03-26",
        "status": "A",
        "authorized_official_last_name": "GUSTAFSON",
        "authorized_official_first_name": "CARL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "781-335-1166"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MA",
            "license": "MA2132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110012664A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diane M Capone, D.C.
• Stephanie Cardarella, M.D.
• Carepro Adult Day Health
• Kristin Nicole Carey, PT, DPT
• Randi Zukas Carhart, MD
• Carmelle's Angels LLC (Carmelle's Angels Home Care)
• Magdelena Carmona
• Carol a. Costello, LMHC, LMFT, LLC
• James Tyler Carpenter, PH.D.
• Cristina Carpio, MD

• Optometrist in Weymouth, MA
• Providers in Weymouth, MA by specialty
• Optometrist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2010; 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.