THOMAS HADLEY GUSTAFSON DPT
NPI 1407105612
Physical Therapist in Niles, MI

Active since September 04, 2012
20 N 2ND ST, SUITE 3, NILES, MI 49120(269) 687-9594(269) 687-9543 Get Directions Write a Review

NPPES record last updated: September 4, 2012. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Thomas Hadley Gustafson Dpt NPPES

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

THOMAS HADLEY GUSTAFSON DPT (NPI 1407105612) is an individual physical therapist in Niles, Michigan, licensed in Michigan (5501016024) and active in the NPI registry since September 2012.

NPPES Registry Identity

NPI1407105612
Entity TypeIndividualMale
Primary Taxonomy225100000X
Provider Legal NameTHOMAS HADLEY GUSTAFSONCredential: DPT
Location Address20 N 2ND ST, SUITE 3Niles, MI 49120-2259
Mailing Address20 N 2nd St, Suite 3Niles, MI 49120-2259 · (269) 687-9594 · Fax (269) 687-9543
Fax(269) 687-9543
Sole ProprietorNo
Enumeration DateSeptember 4, 2012
✔ NPI 1407105612 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225100000X
License✔ Licensed in MI · 5501016024
Definition
Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.
  • Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
  • Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
  • Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.
20 N 2ND ST, Niles, MI 49120

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Thomas Hadley Gustafson Dpt is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show Thomas Gustafson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Physical Therapy
5060 CASCADE RD SE, SUITE A
Grand Rapids, MI 49546
  • Reassigned Medicare billing, Michigan enrollment
  • 31 clinicians in this Medicare group

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

Other Providers at the Same Location NPPES 7

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

Counselor (Professional)
20 N 2ND ST
NILES, MI 49120
Physical Therapist
20 N 2ND ST, SUITE 3
NILES, MI 49120
Optometrist (Low Vision Rehabilitation)
20 N 2ND ST
NILES, MI 49120
Chiropractor (Thermography)
20 N 2ND ST, SUITE 1
NILES, MI 49120
Physical Therapist
20 N 2ND ST, 3
NILES, MI 49120
Chiropractor
20 N 2ND ST, SUITE 1
NILES, MI 49120
Physical Therapist
20 N 2ND ST, SUITE 3
NILES, MI 49120

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 Thomas Gustafson's NPI number?

The NPI number for Thomas Gustafson is 1407105612. It was assigned to this individual provider in the NPPES registry on September 4, 2012.

Where is Thomas Gustafson located?

Thomas Gustafson practices at 20 N 2nd St Suite 3, Niles, MI 49120. The listed phone number is (269) 687-9594.

What is Thomas Gustafson's specialty?

The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.

Is Thomas Gustafson enrolled in Medicare?

Yes. Thomas Gustafson is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Thomas Gustafson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Thomas Gustafson reassigns Medicare benefits to Center For Physical Rehabilitation And Therapy LP (Grand Rapids, MI). The 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 Thomas Gustafson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Thomas Gustafson accept?

Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Thomas 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.

When was this NPI record last updated?

The NPPES record for Thomas Gustafson was last updated on September 4, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.