DR. GEOFFREY PETER GUSTAVSEN (M.D.) – Sports Medicine (Family Medicine) Physician, NPI 1396715959

DR. GEOFFREY PETER GUSTAVSEN (M.D.) is a healthcare provider. based in Newark, Delaware. specializing in FAMILY PRACTICE. They hold the professional credentials M.D.. They hold a License No. C10007058 (DE). The NPI Number for DR. GEOFFREY PETER GUSTAVSEN (M.D.) is 1396715959

Main info

Male
37 Years Of Experience
Accepts Medicare Assignment
Name
DR. GEOFFREY PETER GUSTAVSEN (M.D.)
NPI
1396715959
Phone
(302) 831-2227
Address
282 THE GRN
Enumeration Date
25 January 2006
Last Update Date
26 January 2016

Doctor Profile

Medical School Name
UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE
Secondary Phone
3027384300
Graduation Year
1989 (37 years ago)
PAC ID
4880671338
Group Practice PAC ID
9931620291
Professional Enrollment ID
I20110830000093
Address ID
DE197117150NE324XXSTXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

442 FAMILY PRACTICE in DE

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Provider Addresses for DR. GEOFFREY PETER GUSTAVSEN (M.D.)

  • The Green, Farnsfield CP, Newark and Sherwood, Nottinghamshire, East Midlands, England, NG22 8FN, United Kingdom

    NEWARK, DE 197160009

    Phone: (302) 831-2227

    Fax: (302) 831-6407

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2011-08-30

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20110830000093IFamily PracticeDETBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 19716)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9931620291View full group profile
NameSpecialtyState
Physician AssistantPA
Emergency MedicineDE
Nurse PractitionerDE
Emergency MedicineDE
Internal Medicine, Emergency MedicineDE
Emergency MedicineDE
Emergency MedicineDE
Physician AssistantDE
Emergency MedicineTN
Physician AssistantDE

Reviews

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Frequently asked questions

How do I look up DR. GEOFFREY PETER GUSTAVSEN (M.D.) by NPI?
Use NPI 1396715959 when you need to reference DR. GEOFFREY PETER GUSTAVSEN (M.D.) in forms, claims, or directories.
Is DR. GEOFFREY PETER GUSTAVSEN (M.D.)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What does DR. GEOFFREY PETER GUSTAVSEN (M.D.) treat or focus on?
Patients typically see DR. GEOFFREY PETER GUSTAVSEN (M.D.) under the specialty Sports Medicine (Family Medicine) Physician. Clinical services aligned with this taxonomy classification.
Where does public data place DR. GEOFFREY PETER GUSTAVSEN (M.D.)?
The snapshot lists Newark, Delaware for DR. GEOFFREY PETER GUSTAVSEN (M.D.); download NPPES for the complete set.
Is DR. GEOFFREY PETER GUSTAVSEN (M.D.) a real provider?
This page reflects official NPPES data for NPI 1396715959. Always confirm identity and privileges with the practice and licensing boards.

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