Maria M. Gustilo, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

0420853 Issued in KS

Practice address

500 State Hospital Dr
Osawatomie, KS 66064-1813

Phone

(913) 755-7000

Fax

(913) 755-7127

NPI assigned

Jan 24, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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 KS

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Osawatomie State Hospital

  dba Adair Acute Care at Osawatomie State Hospital

  • Psychiatric Hospital
  • Osawatomie, KS
  • NPI 1184071532

  W-2 Managing Employee

  CMS ownership

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.

• Osawatomie State Hospital

  dba Adair Acute Care at Osawatomie State Hospital

  • Psychiatric Hospital
  • Osawatomie, KS
  • NPI 1184071532
  Medicare reassignment

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962557421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 STATE HOSPITAL DR",
            "city": "OSAWATOMIE",
            "state": "KS",
            "postal_code": "660641813",
            "telephone_number": "913-755-7000",
            "fax_number": "913-755-7127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 STATE HOSPITAL DR",
            "city": "OSAWATOMIE",
            "state": "KS",
            "postal_code": "660641813",
            "telephone_number": "913-755-7000",
            "fax_number": "913-755-7127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTILO",
        "first_name": "MARIA",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KS",
            "license": "0420853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Graves
• Samantha Ann Greenstein
• Cassi Renee Grimes, APRN
• Kathleen M. Grint, APRN
• Mariah Christine Guilfoyle, BHT
• Mary Harber
• Thyrone A. Harriman, M.D.
• Alyson Lyn Hastings
• Laura Lea Henness, LMFT
• Michael Patrick Herriges, ARNP-C

• Psychiatry Physician in Osawatomie, KS
• Providers in Osawatomie, KS by specialty
• Psychiatry Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.