JORDAN RICHARD GUSTAFSON PA-C
NPI 1033678644
Physician Assistant in Nebraska City, NE

Active since March 14, 2019PECOS EnrolledAccepts Medicare Assignment
1301 GRUNDMAN BLVD, NEBRASKA CITY, NE 68410(402) 873-3321 Get Directions Write a Review

NPPES record last updated: March 14, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Jordan Richard Gustafson Pa-c NPPES

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

JORDAN RICHARD GUSTAFSON PA-C (NPI 1033678644) is an individual physician assistant in Nebraska City, Nebraska, licensed in Nebraska (2349) and active in the NPI registry since March 2019. He is enrolled in Medicare PECOS, is affiliated with Chi Health St. Mary's, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1033678644
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameJORDAN RICHARD GUSTAFSONCredential: PA-C
Location Address1301 GRUNDMAN BLVDNebraska City, NE 68410-3319
Mailing Address1301 Grundman BlvdNebraska City, NE 68410-3319 · (402) 873-3321
Sole ProprietorNo
Medical School CMSOtherGraduated 2018
Enumeration DateMarch 14, 2019
NPI 1033678644 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License Licensed in NE · 2349
Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

1301 GRUNDMAN BLVD, Nebraska City, NE 68410

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

Jordan Richard Gustafson Pa-c 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 ID3072853399
PECOS Enrollment IDI20190325001396
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.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Emergency department visit with low level of medical decision making 99283
An emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.
15 services14 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Chi Health St. Mary's

Critical Access Hospitals · Nebraska City, NE
OwnershipVoluntary non-profit - Church
CMS Certification Number281342
Location1301 Grundman BlvdNebraska City, NE 68410 · Otoe County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 68410 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
$81.20 typical visit price
range $52.69 – $160.21
Typical copayment $20.30 (range $13.17 – $40.05)
Most-billed visit code 99203
Established Patient
$66.00 typical visit price
range $16.90 – $131.25
Typical copayment $16.50 (range $4.22 – $32.81)
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.

Referred Medical Equipment & Supplies CMS DME claims 7

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
3 suppliers12 claims44 services$3.08 avg. paid by Medicare
Continuous positive airway pressure (cpap) device E0601
DME-Other DME · category DE001N
2 suppliers35 claims35 services$48.56 avg. paid by Medicare
Arformoterol, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 15 micrograms J7605
DME-Drugs Administered Through DME · category DG006N
2 suppliers14 claims750 services$4.66 avg. paid by Medicare
Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg J7626
DME-Drugs Administered Through DME · category DG000N
2 suppliers12 claims840 services$0.81 avg. paid by Medicare
Revefenacin inhalation solution, fda-approved final product, non-compounded, administered through dme, 1 microgram J7677
DME-Drugs Administered Through DME · category DG006N
2 suppliers16 claims84,000 services$0.15 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
1 supplier12 claims12 services$215.65 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 10

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

Physician Assistant (Medical)
1301 GRUNDMAN BLVD, SUITE A
NEBRASKA CITY, NE 68410
Nurse Anesthetist, Certified Registered
1301 GRUNDMAN BLVD
NEBRASKA CITY, NE 68410
Family Medicine
1301 GRUNDMAN BLVD, SUITE A
NEBRASKA CITY, NE 68410
Physician Assistant
1301 GRUNDMAN BLVD
NEBRASKA CITY, NE 68410
Medicare Defined Swing Bed Unit
1301 GRUNDMAN BLVD
NEBRASKA CITY, NE 68410
General Acute Care Hospital (Critical Access)
1301 GRUNDMAN BLVD
NEBRASKA CITY, NE 68410
Pharmacist
1301 GRUNDMAN BLVD
NEBRASKA CITY, NE 68410
Nurse Practitioner (Family)
1301 GRUNDMAN BLVD
NEBRASKA CITY, NE 68410

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jordan Gustafson's NPI number?

The NPI number for Jordan Gustafson is 1033678644. It was assigned to this individual provider in the NPPES registry on March 14, 2019.

Where is Jordan Gustafson located?

Jordan Gustafson practices at 1301 Grundman Blvd, Nebraska City, NE 68410. The listed phone number is (402) 873-3321.

What is Jordan Gustafson's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Jordan Gustafson enrolled in Medicare?

Yes. Jordan Gustafson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Jordan Gustafson accept?

Health plans from Blue Cross and Blue Shield of Nebraska, Medica and Oscar Insurance Company list Jordan Gustafson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Jordan Gustafson affiliated with any hospitals?

According to CMS data, Jordan Gustafson is affiliated with Chi Health St. Mary's.

When was this NPI record last updated?

The NPPES record for Jordan Gustafson was last updated on March 14, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.