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DR. JILL ELIZABETH GUSTAFSON M.D.
NPI 1497726574
Pediatrics in San Diego, CA

Active since January 27, 2006PECOS Enrolled
5680 DOROTHY WAY, SAN DIEGO, CA 92115(619) 265-9204 Get Directions Write a Review

NPPES record last updated: November 30, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Jill Elizabeth Gustafson M.d. NPPES

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

DR. JILL ELIZABETH GUSTAFSON M.D. (NPI 1497726574) is an individual pediatrics provider in San Diego, California, licensed in California (G72927) and active in the NPI registry since January 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1497726574
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameDR. JILL ELIZABETH GUSTAFSONCredential: M.D.
Location Address5680 DOROTHY WAYSan Diego, CA 92115-2307
Mailing Address5680 Dorothy WaySan Diego, CA 92115-2307 · (619) 265-9204
Phone(619) 265-9204
Sole ProprietorYes
Enumeration DateJanuary 27, 2006
Last NPPES UpdateNovember 30, 2021
NPPES CertifiedNovember 30, 2021
✔ NPI 1497726574 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in CA · G72927
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
5680 DOROTHY WAY, San Diego, CA 92115
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jill Elizabeth Gustafson M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

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

Southern California Permanente Medical Group
2.0 mi
Health Maintenance Organization
4647 ZION AVE
San Diego, CA 92120
  • Reassigned Medicare billing, California enrollment
  • 13,921 clinicians in this Medicare group
NPI 1225060742 (619) 528-5000

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92115 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
$94.87 typical visit price
range $62.10 – $184.71
Typical copayment $23.71 (range $15.52 – $46.17)
Most-billed visit code 99203
Established Patient
$108.42 typical visit price
range $20.62 – $151.42
Typical copayment $27.10 (range $5.15 – $37.85)
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.

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 Jill Gustafson's NPI number?

The NPI number for Jill Gustafson is 1497726574. It was assigned to this individual provider in the NPPES registry on January 27, 2006.

Where is Jill Gustafson located?

Jill Gustafson practices at 5680 Dorothy Way, San Diego, CA 92115. The listed phone number is (619) 265-9204.

What is Jill Gustafson's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Jill Gustafson enrolled in Medicare?

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

Which organization bills Medicare for Jill Gustafson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jill Gustafson reassigns Medicare benefits to Southern California Permanente Medical Group (San Diego, CA). 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 Jill Gustafson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jill Gustafson was last updated on November 30, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.