ERIK J GUSTAFSON DO
NPI 1073042487
Family Medicine in Wausau, WI

Active since June 08, 2017PECOS EnrolledAccepts Medicare Assignment
84.55/100
CMS Quality Rating
425 WIND RIDGE DR, WAUSAU, WI 54401(715) 675-3391 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 21, 2022, Aug 24, 2021, Sep 8, 2018 and 1 more (4 updates tracked since 2017).

About Erik J Gustafson Do NPPES

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

ERIK J GUSTAFSON DO (NPI 1073042487) is an individual family medicine provider in Wausau, Wisconsin, licensed in Wisconsin (69880) and active in the NPI registry since June 2017. He is enrolled in Medicare PECOS, is affiliated with Aspirus Wausau Hospital, and is a graduate of Other (2017).

NPPES Registry Identity

NPI1073042487
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameERIK J GUSTAFSONCredential: DO
Location Address425 WIND RIDGE DRWausau, WI 54401
Mailing Address425 Wind Ridge DrWausau, WI 54401 · (715) 675-3391
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateJune 8, 2017
Last NPPES UpdateJuly 21, 20224 updates tracked since enumeration
NPPES CertifiedAugust 24, 2021
NPI 1073042487 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in WI · 69880
Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

425 WIND RIDGE DR, Wausau, WI 54401

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

Erik J Gustafson Do 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 ID42633232
PECOS Enrollment IDI20200707000702
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 14

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
219 services140 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
181 services122 patients
Blood test, comprehensive group of blood chemicals 80053
A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.
99 services88 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
98 services69 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
98 services98 patients
Complete blood cell count (red cells, white blood cell, platelets), automated test 85027
A complete blood cell count (CBC) is an automated test that measures different components of the blood, including red cells, white cells, and platelets. It helps assess overall health, detect disorders like anemia or infection, and monitor medical treatments.
78 services73 patients

Hospital Affiliations CMS Care Compare

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

Aspirus Wausau Hospital

Acute Care Hospitals · Wausau, WI
4/5 CMS rating
OwnershipProprietary
CMS Certification Number520030
Location333 Pine Ridge BlvdWausau, WI 54401 · Marathon County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54401 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
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
Established Patient
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
Most-billed visit code 99214
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.

84.55/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality91.81
Promoting Interoperability100
Improvement Activities40
Cost53.8

Referred Medical Equipment & Supplies CMS DME claims 2

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
7 suppliers16 claims29 services$4.77 avg. paid by Medicare
Standard wheelchair K0001
DME-Wheelchairs · category DD000N
1 supplier11 claims11 services$22.55 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 20

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

Durable Medical Equipment & Medical Supplies
425 WIND RIDGE DR
WAUSAU, WI 54401
Family Medicine
425 WIND RIDGE DR
WAUSAU, WI 54401
Pediatrics
425 WIND RIDGE DR
WAUSAU, WI 54401
Nurse Practitioner (Family)
425 WIND RIDGE DR
WAUSAU, WI 54401
Psychologist (Clinical)
425 WIND RIDGE DR
WAUSAU, WI 54401
Family Medicine
425 WIND RIDGE DR
WAUSAU, WI 54401
Family Medicine
425 WIND RIDGE DR
WAUSAU, WI 54401
Clinic/Center (Multi-Specialty)
425 WIND RIDGE DR
WAUSAU, WI 54401

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 Erik Gustafson's NPI number?

The NPI number for Erik Gustafson is 1073042487. It was assigned to this individual provider in the NPPES registry on June 8, 2017.

Where is Erik Gustafson located?

Erik Gustafson practices at 425 Wind Ridge Dr, Wausau, WI 54401. The listed phone number is (715) 675-3391.

What is Erik Gustafson's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Erik Gustafson enrolled in Medicare?

Yes. Erik 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 Erik Gustafson accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, HealthPartners and Security Health Plan list Erik 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 Erik Gustafson affiliated with any hospitals?

According to CMS data, Erik Gustafson is affiliated with Aspirus Wausau Hospital.

When was this NPI record last updated?

The NPPES record for Erik Gustafson was last updated on July 21, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.