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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MALLORY M GUSTAFSON ARNP
NPI 1144728486
Nurse Practitioner - Family in Daytona Beach, FL

Active since January 31, 2018PECOS EnrolledAccepts Medicare Assignment
103 MEMORIAL MEDICAL PKWY STE 200, DAYTONA BEACH, FL 32117(386) 615-1521(386) 671-0694 Get Directions Write a Review

NPPES record last updated: October 12, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Mallory M Gustafson Arnp NPPES

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

MALLORY M GUSTAFSON ARNP (NPI 1144728486) is an individual family provider in Daytona Beach, Florida, licensed in Florida (ARNP9383627) and active in the NPI registry since January 2018. She is enrolled in Medicare PECOS, is affiliated with Adventhealth Daytona Beach, and is a graduate of Other (2017).

NPPES Registry Identity

NPI1144728486
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMALLORY M GUSTAFSONCredential: ARNP
Location Address103 MEMORIAL MEDICAL PKWY STE 200Daytona Beach, FL 32117-5672
Mailing Address103 Memorial Medical Pkwy Ste 200Daytona Beach, FL 32117-5672 · (386) 615-1521 · Fax (386) 671-0694
Phone(386) 615-1521
Fax(386) 671-0694
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateJanuary 31, 2018
Last NPPES UpdateOctober 12, 2026
NPPES CertifiedOctober 12, 2026
✔ NPI 1144728486 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in FL · ARNP9383627
103 MEMORIAL MEDICAL PKWY STE 200, Daytona Beach, FL 32117
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, UnitedHealthcare.Insurance ›

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

Mallory M Gustafson Arnp 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 ID446514921
PECOS Enrollment IDI20180509001387
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.

Medicare Billing Reassignments

3

Medicare enrollment records show Mallory Gustafson reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Cardiology Physicians Memorial, LLC
Same address
Interventional Cardiology
103 MEMORIAL MEDICAL PKWY, SUITE 200
Daytona Beach, FL 32117
  • Reassigned Medicare billing, Florida enrollment
  • 14 clinicians in this Medicare group
NPI 1740559855 (386) 615-1521
Excellence Health, LLC
3.3 mi
Family Medicine
1630 MASON AVE STE C
Daytona Beach, FL 32117
  • Reassigned Medicare billing, Florida enrollment
  • 70 clinicians in this Medicare group
NPI 1447741749 (386) 238-9064
Emergency Physicians Of Central Florida LLP
52 mi
Emergency Medicine
1414 S ORANGE AVE, MP 156
Orlando, FL 32806
  • Reassigned Medicare billing, Florida enrollment
  • 347 clinicians in this Medicare group
NPI 1326033341 (407) 841-5111

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare

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

Adventhealth Daytona Beach

Acute Care Hospitals · Daytona Beach, FL
5/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number100068
Location301 Memorial Medical ParkwayDaytona Beach, FL 32117 · Volusia County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32117 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
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
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.

Other Providers at the Same Location NPPES 5

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

CHRISTY LENT APRN
Nurse Practitioner (Family)
103 MEMORIAL MEDICAL PKWY STE 200
DAYTONA BEACH, FL 32117
Volusia County (386) 615-1521
NATHANIEL L VALIN M.D.
Internal Medicine (Interventional Cardiology)
103 MEMORIAL MEDICAL PKWY STE 200
DAYTONA BEACH, FL 32117
Volusia County (386) 615-1521
DAVID A HENDERSON M.D.
Internal Medicine (Interventional Cardiology)
103 MEMORIAL MEDICAL PKWY STE 200
DAYTONA BEACH, FL 32117
Volusia County (386) 615-1521
DR. RENE CELIS MD
Internal Medicine (Interventional Cardiology)
103 MEMORIAL MEDICAL PKWY STE 200
DAYTONA BEACH, FL 32117
Volusia County (386) 615-1521
DINESH ARAB M.D.
Internal Medicine (Interventional Cardiology)
103 MEMORIAL MEDICAL PKWY STE 200
DAYTONA BEACH, FL 32117
Volusia County (386) 615-1521

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 Mallory Gustafson's NPI number?

The NPI number for Mallory Gustafson is 1144728486. It was assigned to this individual provider in the NPPES registry on January 31, 2018.

Where is Mallory Gustafson located?

Mallory Gustafson practices at 103 Memorial Medical Pkwy Ste 200, Daytona Beach, FL 32117. The listed phone number is (386) 615-1521.

What is Mallory Gustafson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Mallory Gustafson enrolled in Medicare?

Yes. Mallory 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 Mallory Gustafson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mallory Gustafson reassigns Medicare benefits to 3 organizations: Cardiology Physicians Memorial, LLC (Daytona Beach, FL), Excellence Health, LLC (Daytona Beach, FL) and Emergency Physicians Of Central Florida LLP (Orlando, FL). 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 Mallory Gustafson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Mallory Gustafson accept?

Health plans from Ambetter Health, Ambetter from Superior HealthPlan and UnitedHealthcare list Mallory 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 Mallory Gustafson affiliated with any hospitals?

According to CMS data, Mallory Gustafson is affiliated with Adventhealth Daytona Beach.

When was this NPI record last updated?

The NPPES record for Mallory Gustafson was last updated on October 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 days 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.