MR. ANDREW KIRBY GUSTAVSON PA-C
NPI 1306571302
Physician Assistant in Waxhaw, NC

Active since July 22, 2022PECOS EnrolledAccepts Medicare Assignment
3614 PROVIDENCE RD S STE 200, WAXHAW, NC 28173(704) 384-8640(704) 384-8650 Get Directions Write a Review

NPPES record last updated: December 28, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 28, 2022, Jul 22, 2022 (2 updates tracked since 2022).

About Mr. Andrew Kirby Gustavson Pa-c NPPES

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

MR. ANDREW KIRBY GUSTAVSON PA-C (NPI 1306571302) is an individual physician assistant in Waxhaw, North Carolina, licensed in North Carolina (0010-12435) and active in the NPI registry since July 2022. He is enrolled in Medicare PECOS, is affiliated with Novant Health Presbyterian Medical Center, and maintains a secondary practice location in Gastonia.

NPPES Registry Identity

NPI1306571302
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMR. ANDREW KIRBY GUSTAVSONCredential: PA-C
Location Address3614 PROVIDENCE RD S STE 200Waxhaw, NC 28173-6310
Mailing AddressPo Box 60447Charlotte, NC 28260-0447
Fax(704) 384-8650
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateJuly 22, 2022
Last NPPES UpdateDecember 28, 20222 updates tracked since enumeration
NPPES CertifiedDecember 28, 2022
NPI 1306571302 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 NC · 0010-12435
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.
3614 PROVIDENCE RD S STE 200, Waxhaw, NC 28173

Secondary Practice Location 1

Location 12682 Court Dr Ste BGastonia, NC 28054-1442 · Phone (704) 824-0500

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

Mr. Andrew Kirby Gustavson 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 ID5395121156
PECOS Enrollment IDI20221118001648
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 12

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.

Manual urinalysis test with examination using microscope, non-automated 81000
A manual urinalysis test involves studying a urine sample under a microscope. This non-automated method helps identify any abnormal substances present. It's a useful tool for detecting potential health concerns early. The process is simple and non-invasive.
154 services131 patients
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.
151 services130 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.
111 services101 patients
Ultrasound measurement of bladder capacity after voiding 51798
Ultrasound measurement of bladder capacity after voiding is a non-invasive test that uses sound waves to create images of your bladder. It's done after you've emptied your bladder to see if there's any leftover urine, which can help diagnose certain conditions.
88 services79 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
80 services30 patients
Simple change of bladder tube 51705
A simple change of bladder tube involves replacing your current urinary drainage tube with a new one. This is done to maintain hygiene and prevent infections. It's a straightforward process, usually causing minimal discomfort, and helps ensure your body can properly dispose of waste fluids.
46 services13 patients

Hospital Affiliations CMS Care Compare 4

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

Novant Health Presbyterian Medical Center

Acute Care Hospitals · Charlotte, NC
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number340053
Location200 Hawthorne Lane Box 33549Charlotte, NC 28233 · Mecklenburg County
Emergency services Birthing friendly

Novant Health Matthews Medical Center

Acute Care Hospitals · Matthews, NC
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number340171
Location1500 Matthews Twnshp Prkwy Box 3310Matthews, NC 28106 · Mecklenburg County
Emergency services Birthing friendly

Novant Health Mint Hill Medical Center

Acute Care Hospitals · Charlotte, NC
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number340190
Location8201 Healthcare LoopCharlotte, NC 28215 · Mecklenburg County
Emergency services Birthing friendly

Novant Health Ballantyne Medical Center

Acute Care Hospitals · Charlotte, NC
OwnershipVoluntary non-profit - Private
CMS Certification Number340195
Location10905 Providence Road WCharlotte, NC 28277 · Mecklenburg County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28173 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
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$67.72 typical visit price
range $17.21 – $134.61
Typical copayment $16.93 (range $4.30 – $33.65)
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 6

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

Family Medicine
3614 PROVIDENCE RD S STE 200
WAXHAW, NC 28173
Family Medicine
3614 PROVIDENCE RD S STE 200
WAXHAW, NC 28173
Nurse Practitioner
3614 PROVIDENCE RD S STE 200
WAXHAW, NC 28173
Nurse Practitioner
3614 PROVIDENCE RD S STE 200
WAXHAW, NC 28173
Family Medicine
3614 PROVIDENCE RD S STE 200
WAXHAW, NC 28173
Family Medicine
3614 PROVIDENCE RD S STE 200
WAXHAW, NC 28173

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 Andrew Gustavson's NPI number?

The NPI number for Andrew Gustavson is 1306571302. It was assigned to this individual provider in the NPPES registry on July 22, 2022.

Where is Andrew Gustavson located?

Andrew Gustavson practices at 3614 Providence Rd S Ste 200, Waxhaw, NC 28173. The listed phone number is (704) 384-8640.

What is Andrew Gustavson's specialty?

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

Is Andrew Gustavson enrolled in Medicare?

Yes. Andrew Gustavson 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 Andrew Gustavson accept?

Health plans from UnitedHealthcare list Andrew Gustavson 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 Andrew Gustavson affiliated with any hospitals?

According to CMS data, Andrew Gustavson is affiliated with Novant Health Presbyterian Medical Center, Novant Health Matthews Medical Center, Novant Health Mint Hill Medical Center and Novant Health Ballantyne Medical Center.

When was this NPI record last updated?

The NPPES record for Andrew Gustavson was last updated on December 28, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.