Evan Gustavsen, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

6426 Issued in ID

Practice address

2302 N Bogus Basin Rd Ste C
Boise, ID 83702-1024

Phone

(208) 344-0737

Fax

(208) 344-0759

NPI assigned

Aug 1, 2019

Sex

Female

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 ID

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physical Therapy at Thrive, LLCGroup PAC ID 4486705217, 6 clinicians

Physical Therapy 180 LLCGroup PAC ID 9830422955, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Physical Therapy 180 LLC

  • Physical Therapist
  • Boise, ID
  • NPI 1669696910
  Medicare reassignment Care Compare group NPD
• Physical Therapy at Thrive, LLC

  • Orthopedic Physical Therapist
  • Boise, ID
  • NPI 1578799094
  Medicare reassignment Care Compare group NPD
• CSRM LLC

  • Physical Therapist
  • Boise, ID
  • NPI 1669132353
  Medicare reassignment NPD
• Sawtooth Physical Therapy

  • Physical Therapy Clinic/Center
  • Boise, ID
  • NPI 1013206002

  Physical Therapist

  Medicare reassignment NPD
• CSRM LLC

  • Hand Occupational Therapist
  • Nampa, ID
  • NPI 1306583109
  NPD
• Sawtooth Physical Therapy

  • Hand Occupational Therapist
  • Meridian, ID
  • NPI 1003582040
  NPD
• Peregrine Physical Therapy LLC

  • Physical Therapist
  • Boise, ID
  • NPI 1942128137
  NPD (past)

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

{
    "created_epoch": "1564617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775692800000",
    "number": "1932754496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2302 N BOGUS BASIN RD STE C",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837021024",
            "telephone_number": "208-344-0737",
            "fax_number": "208-344-0759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2302 N BOGUS BASIN RD STE C",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837021024",
            "telephone_number": "208-344-0737",
            "fax_number": "208-344-0759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTAVSEN",
        "first_name": "EVAN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-01",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "6426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandi Gustafson, DPT
• Jill Reena Gustafson, CNM
• Gustavel Orthopedics PLLC
• Michael J Gustavel, MD
• Terry L Gustavel, D.D.S.
• Jill Guth, BA
• Brittany Guthrie, PA-C
• Cameron J Guthrie, PA
• Camilla Guthrie, NP
• Connor Guthrie

• Physical Therapist in Boise, ID
• Providers in Boise, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2026; 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.

Verify at the official NPI Registry.