L MARK GUSTAFSON (M.D.) – Otolaryngology Physician, NPI 1073555629
Otolaryngology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
392 OTOLARYNGOLOGY in GA
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Provider Addresses for L MARK GUSTAFSON (M.D.)
150, Clinic Avenue, Carrollton, Carroll County, Georgia, 30117, United States
SUITE 201
CARROLLTON, GA 301174401
Phone: (770) 832-1488
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)
CMS reports 3 Open Payments records for all available years, with a total value of $82.
Total Amount is formed as General ($82) + Research ($0) + Ownership ($0) = $82.
Last reported payment date: 2024-10-29 • Largest payer in this snapshot: Davol Inc. ($48).
Total Amount
$82
General + Research + Ownership
Payments
3
Total payment records
General Amount
$82
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-29
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Davol Inc. | $48 |
| GENZYME CORPORATION | $19 |
| GlaxoSmithKline, LLC. | $16 |
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: 2008-06-03
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 |
|---|---|---|---|---|
| I20080603000158 | I | Otolaryngology | GA | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 467 | 302 | $0 |
| 92567 | Test to assess middle ear function | 186 | 170 | $0 |
| 92557 | Comprehensive hearing and speech recognition test | 133 | 127 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 129 | 129 | $0 |
| 96372 | Injection of drug or substance under skin or into muscle | 108 | 90 | $0 |
Insurance plans in this area (ZIP 30117)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| General Surgery | TN | |
| O T O L A R Y N G O L O G Y | GA | |
| - | GA | |
| Nurse Practitioner | GA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | GA | |
| Internal Medicine, Interventional Cardiology, Cardiovascular Disease (Cardiology) | GA | |
| Infectious Disease | GA | |
| U R O L O G Y | GA | |
| - | GA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | GA |
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