JOHN L GUSTAVSON (PH.D.) – Clinical Neuropsychologist, NPI 1720068059
Clinical Neuropsychologist
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Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
747 CLINICAL PSYCHOLOGIST in CO
Provider Addresses for JOHN L GUSTAVSON (PH.D.)
300 W Ottley Ave
Fruita, CO 815212118
Phone: (970) 858-2527
Fax: (970) 858-8684
Type: Location
2530, North 8th Street, Westwood Estates, Grand Junction, Mesa County, Colorado, 81501, United States
SUITE 204
GRAND JUNCTION, CO 815018857
Phone: (970) 245-3505
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-06-24
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040624000354 | I | Clinical Psychologist | CO | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 90837 | Psychotherapy, 1 hour | 167 | 44 | $0 |
| 96137 | Administration of psychological or neuropsychological test, each additional 30 minutes | 76 | 19 | $0 |
| 90791 | Psychiatric diagnostic evaluation | 43 | 43 | $0 |
| 96136 | Administration of psychological or neuropsychological test, first 30 minutes | 20 | 20 | $0 |
Insurance plans in this area (ZIP 81521)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Clinical Psychologist | OR | |
| Clinical Psychologist | CO | |
| Clinical Psychologist | CO |
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