CARL GUSTAFSON (PT) – Physical Therapist, NPI 1225119597
Physical Therapist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,873 PHYSICAL THERAPIST IN PRIVATE PRACTICE in MA
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Provider Addresses for CARL GUSTAFSON (PT)
790, Remington Boulevard, Bolingbrook, Will County, Illinois, 60440, United States
BOLINGBROOK, IL 604404909
Phone: (630) 296-2223
Type: Mailing
2, Laurel Avenue, Linden Street, Wellesley Hills, Wellesley, Norfolk County, Massachusetts, 02481, United States
WELLESLEY, MA 024817523
Phone: (781) 237-5585
Fax: (781) 237-5633
Type: Location
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: 2012-01-04
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 |
|---|---|---|---|---|
| I20120104000671 | I | Physical Therapist In Private Practice | MA | 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 |
|---|---|---|---|---|
| 97110 | Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 112 | 14 | $0 |
| 97161 | Evaluation for physical therapy, typically 20 minutes | 13 | 13 | $0 |
Insurance plans in this area (ZIP 60440)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICAL THERAPY | MA | 97001 | Physical therapy evaluation | 54 | 45 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Orthopedic Surgery | MA | |
| Sports Medicine, Emergency Medicine | MA | |
| Physician Assistant | MA | |
| Clinical Psychologist | MA | |
| Orthopedic Surgery, Sports Medicine | MA | |
| Internal Medicine, Sports Medicine | MA | |
| - | MA | |
| Orthopedic Surgery, Sports Medicine | MA | |
| Orthopedic Surgery | MA | |
| - | MA |
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