DR. KEVIN MITSUTOSHI GUSTAFSON MD
NPI 1093210981
Ophthalmology in Santa Ana, CA
About Dr. Kevin Mitsutoshi Gustafson Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. KEVIN MITSUTOSHI GUSTAFSON MD (NPI 1093210981) is an individual ophthalmology provider in Santa Ana, California, licensed in California (A165714) and active in the NPI registry since March 2018. He is enrolled in Medicare PECOS and is a graduate of University Of California, Irvine, California College Of Medicine (2018).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Kevin Mitsutoshi 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.
Medicare Billing Reassignments
3Medicare enrollment records show Kevin Gustafson reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Orange, CA 92868
- Reassigned Medicare billing, California enrollment
- 85 clinicians in this Medicare group
Orange, CA 92868
- Reassigned Medicare billing, California enrollment
- 113 clinicians in this Medicare group
Anaheim, CA 92807
- Reassigned Medicare billing, California enrollment
- 13,921 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 92704 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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 Kevin Gustafson's NPI number?
The NPI number for Kevin Gustafson is 1093210981. It was assigned to this individual provider in the NPPES registry on March 24, 2018.
Where is Kevin Gustafson located?
Kevin Gustafson practices at 3401 S Harbor Blvd, Santa Ana, CA 92704. The listed phone number is (888) 988-2800.
What is Kevin Gustafson's specialty?
The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.
Is Kevin Gustafson enrolled in Medicare?
Yes. Kevin 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.
Which organizations bill Medicare for Kevin Gustafson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kevin Gustafson reassigns Medicare benefits to 3 organizations: Regents Of The University Of California (Orange, CA), Regents Of The University Of California (Orange, CA) and Southern California Permanente Medical Group (Anaheim, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kevin Gustafson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Kevin Gustafson was last updated on October 27, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Kevin Mitsutoshi Gustafson, MD · NPI 1093210981
Ophthalmology physician in Santa Ana, California. Individual provider, active in the CMS NPPES registry since March 24, 2018.
## Identity
- **NPI:** 1093210981 (Entity type: Individual)
- **Enumerated:** March 24, 2018
- **Primary specialty:** Ophthalmology · taxonomy 207W00000X
- **State license:** A165714 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 3401 S HARBOR BLVD, Santa Ana, CA 92704-7933
- **Phone:** (888) 988-2800
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Regents Of The University Of California (NPI 1487602579, Orange, CA); Regents Of The University Of California (NPI 1871541953, Orange, CA); Southern California Permanente Medical Group (NPI 1952333460, Anaheim, CA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of California, Irvine, California College Of Medicine, class of 2018
## Record status
- **NPPES last updated:** October 27, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1093210981) · Data from the CMS NPPES public registry.