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GREGORY ROBERT GUSTAVSON APRN
NPI 1770418030
Nurse Practitioner - Acute Care in Willimantic, CT

Active since June 16, 2026PECOS Enrolled
112 MANSFIELD AVE, WILLIMANTIC, CT 06226(860) 456-9116 Get Directions Write a Review

NPPES record last updated: August 18, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Gregory Robert Gustavson Aprn NPPES

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

GREGORY ROBERT GUSTAVSON APRN (NPI 1770418030) is an individual acute care provider in Willimantic, Connecticut, licensed in Connecticut (92342) and active in the NPI registry since June 2026. He is enrolled in Medicare PECOS, maintains 3 additional practice locations, and is a graduate of Other (2026).

NPPES Registry Identity

NPI1770418030
Entity TypeIndividualMale
Primary Taxonomy363LA2100X
Provider Legal NameGREGORY ROBERT GUSTAVSONCredential: APRN
Location Address112 MANSFIELD AVEWillimantic, CT 06226-2040
Mailing Address5 Beaudet TerColumbia, CT 06237-1404 · (860) 617-0730
Phone(860) 456-9116
Sole ProprietorNo
Medical School CMSOtherGraduated 2026
Enumeration DateJune 16, 2026
Last NPPES UpdateAugust 18, 2026
NPPES CertifiedAugust 18, 2026
✔ NPI 1770418030 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2100X
License✔ Licensed in CT · 92342
Also ListedRadiology · Vascular & Interventional RadiologyTaxonomy 2085R0204X · License 12.017664 (CT)
Also ListedNurse Practitioner · GerontologyTaxonomy 363LG0600X · License 92342 (CT)
112 MANSFIELD AVE, Willimantic, CT 06226
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Other Names 1

Other Name (5)Greg Robert Gustavson Aprn

Secondary Practice Locations 3

Location 1435 Lewis AveMeriden, CT 06451-2101 · Phone (203) 694-8928
Location 2326 Washington StNorwich, CT 06360-2740 · Phone (860) 889-8331
Location 3100 Grand StNew Britain, CT 06052-2016 · Phone (860) 276-5000

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Gregory Robert Gustavson Aprn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4486113784
PECOS Enrollment IDI20260827000445
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 Reassignments

3

Medicare enrollment records show Gregory Gustavson reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Midstate Radiology Associates, LLC
32 mi
Diagnostic Radiology
435 LEWIS AVE
Meriden, CT 06451
  • Reassigned Medicare billing, Connecticut enrollment
  • 110 clinicians in this Medicare group
NPI 1578518999 (203) 949-2700
Meriden Imaging Center, Inc.
34 mi
Diagnostic Radiology
863 N MAIN STREET EXT
Wallingford, CT 06492
  • Reassigned Medicare billing, Connecticut enrollment
  • 108 clinicians in this Medicare group
NPI 1508812561 (203) 294-2721
Vein Centers, LLC
36 mi
Diagnostic Radiology
22 PINE ST
Bristol, CT 06010
  • Reassigned Medicare billing, Connecticut enrollment
  • 11 clinicians in this Medicare group
NPI 1639739634 (844) 868-1001

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 06226 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
$93.86 typical visit price
range $60.82 – $183.10
Typical copayment $23.46 (range $15.20 – $45.77)
Most-billed visit code 99203
Established Patient
$106.68 typical visit price
range $19.76 – $149.26
Typical copayment $26.67 (range $4.94 – $37.31)
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.

Other Providers at the Same Location NPPES 20

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

BETHANY JOY KENNEDY APRN
Nurse Practitioner (Acute Care)
112 MANSFIELD AVE
WILLIMANTIC, CT 06226
Southeastern Connecticut Planning Region (860) 456-9116
MARLENE SCHWARTZ M.D.
Internal Medicine (Pulmonary Disease)
112 MANSFIELD AVE, PULMONARY DISEASE DIVISION, HATCH WING
WILLIMANTIC, CT 06226
Southeastern Connecticut Planning Region (860) 456-7279
WINDHAM COMMUNITY MEMORIAL HOSPITAL, INC.
General Acute Care Hospital
112 MANSFIELD AVE
WILLIMANTIC, CT 06226
Southeastern Connecticut Planning Region (860) 456-6752
LORI BERNIER LCSW
Social Worker (Clinical)
112 MANSFIELD AVE
WILLIMANTIC, CT 06226
Southeastern Connecticut Planning Region (860) 456-6793
JESSICA LISE VERCRUYSSE MD
Emergency Medicine
112 MANSFIELD AVE
WILLIMANTIC, CT 06226
Southeastern Connecticut Planning Region (904) 265-6850
SAMER T MORCOS MD
Internal Medicine (Pulmonary Disease)
112 MANSFIELD AVE
WILLIMANTIC, CT 06226
Southeastern Connecticut Planning Region (860) 456-6713
ERIN CURRY BANE DNP CNM
Midwife
112 MANSFIELD AVE
WILLIMANTIC, CT 06226
Southeastern Connecticut Planning Region (860) 456-6796
JESSICA L ST. LOUIS LCSW
Social Worker (Clinical)
112 MANSFIELD AVE
WILLIMANTIC, CT 06226
Southeastern Connecticut Planning Region (860) 456-6985

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 Gregory Gustavson's NPI number?

The NPI number for Gregory Gustavson is 1770418030. It was assigned to this individual provider in the NPPES registry on June 16, 2026. The provider is also known as Greg Robert Gustavson Aprn.

Where is Gregory Gustavson located?

Gregory Gustavson practices at 112 Mansfield Ave, Willimantic, CT 06226. The listed phone number is (860) 456-9116.

What is Gregory Gustavson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Is Gregory Gustavson enrolled in Medicare?

Yes. Gregory Gustavson is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Gregory Gustavson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Gregory Gustavson reassigns Medicare benefits to 3 organizations: Midstate Radiology Associates, LLC (Meriden, CT), Meriden Imaging Center, Inc. (Wallingford, CT) and Vein Centers, LLC (Bristol, CT). Each 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 Gregory Gustavson'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 Gregory Gustavson was last updated on August 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.