DR. JACQUELINE JEANETTE CARTER GUSTAFSON MD
NPI 1023209632
Surgery in Cleveland, TN

Active since August 08, 2007PECOS EnrolledAccepts Medicare Assignment
76.66/100
CMS Quality Rating
2700 WESTSIDE DR NW STE 204, CLEVELAND, TN 37312(423) 244-9270(423) 244-9255 Get Directions Write a Review

NPPES record last updated: August 20, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Aug 20, 2024, Jan 17, 2022 (2 updates tracked since 2022).

About Dr. Jacqueline Jeanette Carter Gustafson Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JACQUELINE JEANETTE CARTER GUSTAFSON MD (NPI 1023209632) is an individual surgery provider in Cleveland, Tennessee, licensed in Tennessee (MD67660) and active in the NPI registry since August 2007. She is enrolled in Medicare PECOS, maintains a secondary practice location in Smyrna, and is a graduate of Loma Linda University School Of Medicine (2005).

NPPES Registry Identity

NPI1023209632
Entity TypeIndividualFemale
Primary Taxonomy208600000X
Provider Legal NameDR. JACQUELINE JEANETTE CARTER GUSTAFSONCredential: MD
Location Address2700 WESTSIDE DR NW STE 204Cleveland, TN 37312-3682
Mailing Address2700 Westside Dr Nw Ste 204Cleveland, TN 37312-3682 · (423) 244-9270 · Fax (423) 244-9255
Fax(423) 244-9255
Sole ProprietorNo
Medical School CMSLoma Linda University School Of MedicineGraduated 2005
Enumeration DateAugust 8, 2007
Last NPPES UpdateAugust 20, 20242 updates tracked since enumeration
NPPES CertifiedAugust 20, 2024
NPI 1023209632 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License Licensed in TN · MD67660
Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

2700 WESTSIDE DR NW STE 204, Cleveland, TN 37312

Other Names 1

Former Name (1)Jacqueline Carter Md

Secondary Practice Location 1

Location 1515 Stonecrest Pkwy Ste 230Smyrna, TN 37167-6829 · Phone (615) 223-9935

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Jacqueline Jeanette Carter Gustafson Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1456522499
PECOS Enrollment IDI20241031002403
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37312 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.53 typical visit price
range $52.64 – $160.89
Typical copayment $20.38 (range $13.16 – $40.22)
Most-billed visit code 99203
Established Patient
$66.01 typical visit price
range $16.72 – $131.41
Typical copayment $16.50 (range $4.18 – $32.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

76.66/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality58.21
Promoting Interoperability100
Improvement Activities40
Cost56.9

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Psychiatry & Neurology (Psychiatry)
2700 WESTSIDE DR NW STE 204
CLEVELAND, TN 37312

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1023209632, enumerated as an "individual" on August 08, 2007.

The provider is located at 2700 WESTSIDE DR NW STE 204 CLEVELAND, TN 37312 and the phone number is (423) 244-9270.

Surgery with taxonomy code 208600000X.

The provider might be accepting Accepts: BlueCross BlueShield of Tennessee, Oscar Insurance. Please consult your insurance carrier or call the provider to verify.