Troy Gustaveson, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

6477 Issued in AZ

Practice address

5910 N la Cholla Blvd
Tucson, AZ 85741-3535

Phone

(520) 297-0404

Fax

(520) 297-0436

NPI assigned

Oct 21, 2016

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

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ronald M Mann MD PCGroup PAC ID 1456336676, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

87.18 of 100Reported as group

Quality

100

Improvement activities

40

Cost

57.28

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: tgustaveson@directaddress.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ronald M. Mann, M.D. P.C.

  dba Catalina Dermatology

  • Dermatology Physician
  • Tucson, AZ
  • NPI 1861688434
  Medicare reassignment Care Compare group
• Tucson Endocrine Associates PLLC

  • Endocrinology, Diabetes & Metabolism Physician
  • Tucson, AZ
  • NPI 1083766828
  Medicare reassignment

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

{
    "created_epoch": "1477008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483747200000",
    "number": "1902357171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5910 N LA CHOLLA BLVD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857413535",
            "telephone_number": "520-297-0404",
            "fax_number": "520-297-0436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5910 N LA CHOLLA BLVD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857413535",
            "telephone_number": "520-297-0404",
            "fax_number": "520-297-0436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTAVESON",
        "first_name": "TROY",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-21",
        "last_updated": "2017-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "6477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anirudh Gururaj
• Christine A Gurvitz
• Dakota Gust
• Monica R Gustafson, MD
• Troy Charles Gustafson, D.C.
• Chad Guthrie, CRNA
• Sharon R Guthrie, BSN, R.N.,M.ED, LPC
• Arianna Gutierrez, PTA
• Brittani Gutierrez
• Crystal Nicole Gutierrez

• Medical Physician Assistant in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Medical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2017; 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.