MR. ZACHARY R GUSTAVISON PA-C
NPI 1316108970
Physician Assistant in Herrin, IL
NPI Status: Active since June 17, 2008
Contact Information
201 S 14TH ST
HERRIN, IL
ZIP 62948
Phone: (618) 942-2171
Fax: (618) 351-4917
- Individual
- Male
- Physician Assistant
- PECOS Enrolled
- Medicare Quality Reporting
About ZACHARY GUSTAVISON
This page provides the complete NPI Profile along with additional information for Zachary Gustavison, a primary care provider established in Herrin, Illinois with a medical specialization in Physician Assistant. The healthcare provider is registered in the NPI registry with number 1316108970 assigned on June 2008. The practitioner's primary taxonomy code is 363A00000X with license number 085-003467 (IL). The provider is registered as an individual and his NPI record was last updated 2 years ago.
- NPI
- 1316108970
- Provider Name
- MR. ZACHARY R GUSTAVISON PA-C
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 201 S 14TH ST HERRIN, IL 62948
- Location Phone
- (618) 942-2171
- Location Fax
- (618) 351-4917
- Mailing Address
- PO BOX 3988 CARBONDALE, IL 62902
- Mailing Phone
- (618) 457-5200
- Is Sole Proprietor?
- No
- Enumeration Date
- 06-17-2008
- Last Update Date
- 07-18-2024
- Code Navigator
A primary care provider (PCP) like Zachary Gustavison sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Secondary Locations
- 605 N 12th St
Mount Vernon, IL 62864
(586) 263-2601 - 405 W Jackson St
Carbondale, IL 62901
(618) 549-0721 - 1 Saint Anthonys Way
Alton, IL 62002
(618) 465-2571 - 901 S Commercial St
Harrisburg, IL 62946
(618) 993-3817 - 2808 Outer Dr
Marion, IL 62959
(618) 993-3817 - 2 S Hospital Dr
Murphysboro, IL 62966
(618) 684-3156
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Physician Assistant
- Taxonomy Code
- 363A00000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- 085-003467
- License State
- IL
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 5601005286 (MI) |
Medicare Participation & PECOS Enrollment Status
Zachary Gustavison is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Oxygen and Supplies (DC000N)
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)
2 DME suppliers used 30 Medicare Claims 30 Services Paid
DME-Oxygen and Supplies (DC002N)
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)
4 DME suppliers used 38 Medicare Claims 38 Services Paid
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Emergency department visit for life threatening or functioning severity
Follow-up hospital inpatient care per day, typically 25 minutes
Follow-up hospital inpatient care per day, typically 35 minutes
Follow-up nursing facility visit per day, typically 35 minutes
Hospital discharge day management, more than 30 minutes
Hospital observation care on day of discharge
Initial hospital inpatient care per day, typically 70 minutes
Initial hospital observation care per day, typically 70 minutes
Initial nursing facility visit per day, typically 45 minutes
Nursing facility discharge management, more than 30 minutes
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
This service was performed 24 times for 23 patientsFollow-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.
This service was performed 27 times for 12 patientsFollow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
This service was performed 131 times for 61 patientsA follow-up nursing facility visit is a routine check-up that typically lasts about 35 minutes. During this visit, your health status is evaluated, any changes in your condition are noted, and necessary adjustments to your care plan are made. It's an essential part of maintaining your health.
This service was performed 97 times for 52 patientsHospital 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.
This service was performed 48 times for 47 patientsHospital observation care on the day of discharge involves monitoring your health status to ensure stability before you leave. This includes assessing vital signs, response to treatment, and readiness for home care or rehabilitation.
This service was performed 13 times for 13 patientsInitial 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.
This service was performed 38 times for 35 patientsThis service involves a healthcare professional closely monitoring your health condition during your hospital stay. It typically lasts for about 70 minutes each day. This helps in timely detection of any changes in your health, allowing for immediate response and treatment.
This service was performed 23 times for 22 patientsAn initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.
This service was performed 24 times for 23 patientsNursing facility discharge management over 30 minutes is a comprehensive process where a healthcare team prepares you for leaving the facility. It involves creating a tailored plan, coordinating care, and ensuring a smooth transition to your next care setting.
This service was performed 41 times for 39 patientsPhysician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 62948 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $85.71
- Minimum New Patient Price $54.8
- Maximum New Patient Price $168.44
- Average New Patient Copayment $21.42
- Minimum New Patient Copayment $13.7
- Maximum New Patient Copayment $42.11
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $68.64
- Minimum Established Patient Price $17.16
- Maximum Established Patient Price $136.56
- Average Established Patient Copayment $17.16
- Minimum Established Patient Copayment $4.29
- Maximum Established Patient Copayment $34.14
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Consultation of the Prescription Drug Monitoring Program | Yes | N/A |
| Clinicians would attest to reviewing the patients’ history of controlled substance prescription using state prescription drug monitoring program (PDMP) data prior to the issuance of a Controlled Substance Schedule II (CSII) opioid prescription lasting longer than 3 days. For the transition year, clinicians would attest to 60 percent review of applicable patient’s history. For the Quality Payment Program Year 2 and future years, clinicians would attest to 75 percent review of applicable patient’s history performance. | ||
| Measurement and Improvement at the Practice and Panel Level | Yes | N/A |
| Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level. | ||
| Regularly assess the patient experience of care through surveys, advisory councils and/or other mechanisms. | Yes | N/A |
| Regularly assess the patient experience of care through surveys, advisory councils and/or other mechanisms. | ||
| Use of decision support and standardized treatment protocols | Yes | N/A |
| Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs. | ||
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1316108970, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 60. The final step is to find the difference between that total and the next multiple of ten (60 - 60 = 0).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 60 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
HERRIN, IL 62948
HERRIN, IL 62948
HERRIN, IL 62948
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1316108970, enumerated as an "individual" on June 17, 2008.
The provider is located at 201 S 14TH ST HERRIN, IL 62948 and the phone number is (618) 942-2171.
Physician Assistant with taxonomy code 363A00000X.
