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SUSTACHE PRIMARY CARE LLC
NPI 1336955954
Family Medicine in Marlborough, MA

Active since December 09, 2024CLIA 22D2317786 · Waiver
65 BOSTON POST RD W STE 100, MARLBOROUGH, MA 01752(508) 422-4844(351) 202-1665 Get Directions Write a Review

NPPES record last updated: December 9, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Sustache Primary Care Llc NPPES

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

SUSTACHE PRIMARY CARE LLC (NPI 1336955954) is a healthcare organization registered as a family medicine in Marlborough, Massachusetts and active in the NPI registry since December 2024. The organization holds a CLIA Waiver certificate valid through January 30, 2027 and lists Gilberto Sustache, Physician/owner, as its authorized official.

NPPES Registry Identity

NPI1336955954
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSUSTACHE PRIMARY CARE LLC
Location Address65 BOSTON POST RD W STE 100Marlborough, MA 01752-1872
Mailing Address65 Boston Post Rd W Ste 100Marlborough, MA 01752-1872 · (508) 422-4844 · Fax (351) 202-1665
Phone(508) 422-4844
Fax(351) 202-1665
Organization SubpartNo
Authorized OfficialGilberto SustachePhysician/owner · (832) 763-0833
Enumeration DateDecember 9, 2024
NPPES CertifiedDecember 9, 2024
✔ NPI 1336955954 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
65 BOSTON POST RD W STE 100, Marlborough, MA 01752
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sustache Primary Care Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Sustache Primary Care LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Gilberto Sustache, M.D.
Family Practice
NPI 1205898509
65 BOSTON POST RD W STE 100
Marlborough, MA 01752
(508) 422-4844
✔ PECOS✔ Accepts Medicare2.9 mi

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 22D2317786

Sustache Primary Care LLC · Marlborough, MA
Active · expires Jan 30, 2027
CLIA Number22D2317786
Laboratory TypePhysician Office
Certificate Effective DateJanuary 31, 2025
Certificate Expiration DateJanuary 30, 2027
Laboratory DirectorGilberto Sustache
Laboratory Phone(508) 422-4844
Laboratory LocationSustache Primary Care LLC65 Boston Post Road West Suite 100, Marlborough, MA 01752
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Sustache Primary Care LLC's NPI number?

The NPI number for Sustache Primary Care LLC is 1336955954. It was assigned to this organization in the NPPES registry on December 9, 2024.

Where is Sustache Primary Care LLC located?

Sustache Primary Care LLC is located at 65 Boston Post Rd W Ste 100, Marlborough, MA 01752. The listed phone number is (508) 422-4844.

What is Sustache Primary Care LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Sustache Primary Care LLC enrolled in Medicare?

Yes. Sustache Primary Care LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Sustache Primary Care LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Sustache Primary Care LLC. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Sustache Primary Care LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 22D2317786) is associated with this NPI, valid through January 30, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Sustache Primary Care LLC was last updated on December 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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.