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FREDERICK GUSTAVE DDS
NPI 1891709168
Dentist - Oral and Maxillofacial Surgery in Belleville, IL

Active since July 29, 2006Opted out of Medicare · through Jul 1, 2027
10200 W MAIN ST, BELLEVILLE, IL 62223(618) 400-6725(618) 500-6725 Get Directions Write a Review

NPPES record last updated: January 4, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 4, 2024, Dec 15, 2023 (2 updates tracked since 2023).

About Frederick Gustave Dds NPPES

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

FREDERICK GUSTAVE DDS (NPI 1891709168) is an individual oral and maxillofacial surgery provider in Belleville, Illinois, licensed in Illinois (021001098) and active in the NPI registry since July 2006. He has opted out of Medicare through July 1, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1891709168
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameFREDERICK GUSTAVECredential: DDS
Location Address10200 W MAIN STBelleville, IL 62223-1408
Mailing Address10200 W Main StBelleville, IL 62223-1408 · (618) 400-6725 · Fax (618) 500-6725
Phone(618) 400-6725
Fax(618) 500-6725
Sole ProprietorYes
Enumeration DateJuly 29, 2006
Last NPPES UpdateJanuary 4, 20242 updates tracked since enumeration
NPPES CertifiedJanuary 4, 2024
✔ NPI 1891709168 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
Licenses✔ Licensed in IL · 021001098✔ Licensed in IL · 019016600
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
10200 W MAIN ST, Belleville, IL 62223
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Humana, Renaissance Dental.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Frederick Gustave Dds has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 1, 2021 through July 1, 2027.

Opt-Out Effective DateJuly 1, 2021
Opt-Out In Effect ThroughJuly 1, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62223 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
$88.44 typical visit price
range $56.28 – $173.35
Typical copayment $22.11 (range $14.07 – $43.33)
Most-billed visit code 99203
Established Patient
$70.42 typical visit price
range $17.51 – $139.99
Typical copayment $17.60 (range $4.37 – $34.99)
Most-billed visit code 99213
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 3

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

DR. ANDREW PHILIP MONESTERO DDS
Dentist
10200 W MAIN ST
BELLEVILLE, IL 62223
St. Clair County (618) 397-2464
MICHAEL W NOBLE D.M.D.
Dentist (Oral and Maxillofacial Surgery)
10200 W MAIN ST
BELLEVILLE, IL 62223
St. Clair County (618) 397-2464
CENTER FOR ORAL AND MAXILLOFACIAL SURGERY, P.C.
Oral & Maxillofacial Surgery
10200 W MAIN ST, SIGNAL HILL MEDICAL BLDG
BELLEVILLE, IL 62223
St. Clair County (618) 397-2464

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 Frederick Gustave's NPI number?

The NPI number for Frederick Gustave is 1891709168. It was assigned to this individual provider in the NPPES registry on July 29, 2006.

Where is Frederick Gustave located?

Frederick Gustave practices at 10200 W Main St, Belleville, IL 62223. The listed phone number is (618) 400-6725.

What is Frederick Gustave's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Frederick Gustave enrolled in Medicare?

No. Frederick Gustave has opted out of Medicare through July 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Frederick Gustave accept?

Health plans from Humana and Renaissance Dental list Frederick Gustave 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 Frederick Gustave was last updated on January 4, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.