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ADRIANA C GUSATU MD
NPI 1316055759
Internal Medicine in Racine, WI

Active since August 27, 2006PECOS EnrolledAccepts Medicare Assignment
82.39/100
CMS Quality Rating
3801 SPRING STREET, RACINE, WI 53405(262) 687-4011(262) 687-4280 Get Directions Write a Review

NPPES record last updated: December 15, 2016. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Adriana C Gusatu Md NPPES

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

ADRIANA C GUSATU MD (NPI 1316055759) is an individual internal medicine provider in Racine, Wisconsin, licensed in Wisconsin (51292) and active in the NPI registry since August 2006. She is enrolled in Medicare PECOS, is affiliated with Ascension All Saints Hospital, and is a graduate of Other (1996).

NPPES Registry Identity

NPI1316055759
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameADRIANA C GUSATUCredential: MD
Location Address3801 SPRING STREETRacine, WI 53405-1667
Mailing Address3801 Spring StreetRacine, WI 53405-1667 · (262) 687-4011 · Fax (262) 687-4280
Phone(262) 687-4011
Fax(262) 687-4280
Sole ProprietorNo
Medical School CMSOtherGraduated 1996
Enumeration DateAugust 27, 2006
Last NPPES UpdateDecember 15, 2016
✔ NPI 1316055759 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in WI · 51292
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
3801 SPRING STREET, Racine, WI 53405
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.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

Adriana C Gusatu 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 ID4880602606
PECOS Enrollment IDI20080326000766
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 4

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.

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.
261 services106 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
72 services71 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
47 services19 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
30 services30 patients

Hospital Affiliations CMS Care Compare

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

Ascension All Saints Hospital

Acute Care Hospitals · Racine, WI
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number520096
Location3801 Spring StRacine, WI 53405 · Racine County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53405 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
$123.69 typical visit price
range $53.90 – $163.24
Typical copayment $30.92 (range $13.47 – $40.81)
Most-billed visit code 99204
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.

82.39/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality77.88
Promoting Interoperability81
Improvement Activities40
Cost74.38

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.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
3 suppliers22 claims22 services$17.97 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
4 suppliers31 claims31 services$99.46 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 4

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

DR. MICHAEL VINCENT KOWAL D.O.
Emergency Medicine
3801 SPRING STREET
RACINE, WI 53405
Racine County (262) 687-4011
MARCIA KAY HAYEK R.D.
Dietitian, Registered
3801 SPRING STREET, WHEATON FRANCISCAN HEALTHCARE - ALL SAINTS
RACINE, WI 53405
Racine County (262) 687-4279
DR. KEVIN COOPER DO
Internal Medicine
3801 SPRING STREET
RACINE, WI 53405
Racine County (262) 687-4011
MS. NIYA SHARRON BEALIN MS
Psychologist (School)
3801 SPRING STREET
RACINE, WI 53405
Racine County (262) 687-4011

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 Adriana Gusatu's NPI number?

The NPI number for Adriana Gusatu is 1316055759. It was assigned to this individual provider in the NPPES registry on August 27, 2006.

Where is Adriana Gusatu located?

Adriana Gusatu practices at 3801 Spring Street, Racine, WI 53405. The listed phone number is (262) 687-4011.

What is Adriana Gusatu's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Adriana Gusatu enrolled in Medicare?

Yes. Adriana Gusatu 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 Adriana Gusatu accept?

Health plans from Anthem Blue Cross and Blue Shield list Adriana Gusatu 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 Adriana Gusatu affiliated with any hospitals?

According to CMS data, Adriana Gusatu is affiliated with Ascension All Saints Hospital.

When was this NPI record last updated?

The NPPES record for Adriana Gusatu was last updated on December 15, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.