DR. KEVIN MITSUTOSHI GUSTAFSON MD
NPI 1093210981
Ophthalmology in Santa Ana, CA

Active since March 24, 2018PECOS EnrolledAccepts Medicare Assignment
3401 S HARBOR BLVD, SANTA ANA, CA 92704(888) 988-2800 Get Directions Write a Review

NPPES record last updated: October 27, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Oct 27, 2023, Aug 24, 2023, Jan 17, 2023 and 2 more (5 updates tracked since 2018).

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

NPI1093210981
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameDR. KEVIN MITSUTOSHI GUSTAFSONCredential: MD
Location Address3401 S HARBOR BLVDSanta Ana, CA 92704-7933
Mailing Address3401 S Harbor BlvdSanta Ana, CA 92704-7933 · (888) 988-2800
Sole ProprietorNo
Medical School CMSUniversity Of California, Irvine, California College Of MedicineGraduated 2018
Enumeration DateMarch 24, 2018
Last NPPES UpdateOctober 27, 20235 updates tracked since enumeration
NPPES CertifiedAugust 24, 2023
NPI 1093210981 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License Licensed in CA · A165714
Definition

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

3401 S HARBOR BLVD, Santa Ana, CA 92704

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. 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.

PECOS PAC ID2668804584
PECOS Enrollment IDI20220525002490
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.

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.
27 services14 patients

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.

New Patient
$142.39 typical visit price
range $62.96 – $187.60
Typical copayment $35.59 (range $15.74 – $46.90)
Most-billed visit code 99204
Established Patient
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
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.

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.

Pharmacist
3401 S HARBOR BLVD
SANTA ANA, CA 92704
Family Medicine
3401 S HARBOR BLVD
SANTA ANA, CA 92704
Pharmacist
3401 S HARBOR BLVD
SANTA ANA, CA 92704
Dermatology
3401 S HARBOR BLVD
SANTA ANA, CA 92704
Family Medicine
3401 S HARBOR BLVD
SANTA ANA, CA 92704
Family Medicine (Adult Medicine)
3401 S HARBOR BLVD
SANTA ANA, CA 92704
Family Medicine
3401 S HARBOR BLVD
SANTA ANA, CA 92704
Nurse Practitioner (Family)
3401 S HARBOR BLVD
SANTA ANA, CA 92704

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.

When was this NPI record last updated?

The NPPES record for Kevin Gustafson was last updated on October 27, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.