DR. CHAD AMBROSE GUSTIN (M.D.) – Emergency Medicine Physician, NPI 1104086586

DR. CHAD AMBROSE GUSTIN (M.D.) is a healthcare provider. based in Lawrence, Kansas. specializing in EMERGENCY MEDICINE. They hold the professional credentials M.D.. They hold a License No. M5739 (TX). The NPI Number for DR. CHAD AMBROSE GUSTIN (M.D.) is 1104086586

Main info

Male
21 Years Of Experience
Accepts Medicare Assignment
Name
DR. CHAD AMBROSE GUSTIN (M.D.)
NPI
1104086586
Phone
(785) 505-5000
Address
325 MAINE ST
Enumeration Date
10 June 2008
Last Update Date
19 March 2014

Doctor Profile

Medical School Name
UNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
Secondary Phone
7855055000
Graduation Year
2005 (21 years ago)
PAC ID
4880768100
Group Practice PAC ID
1052730025
Professional Enrollment ID
I20080805000547
Address ID
KS660441360LA325XXSTXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness75
Years active:18State licenses:2Digital endpointsOther names

453 EMERGENCY MEDICINE in KS

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Provider Addresses for DR. CHAD AMBROSE GUSTIN (M.D.)

  • Lawrence Memorial Hospital, 325, Maine Street, Pinckney, Lawrence, Douglas County, Kansas, 66044, United States

    LAWRENCE, KS 660441360

    Phone: (785) 505-5000

    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: 2008-08-05

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
I20080805000547IEmergency MedicineKSTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99285Emergency department visit with high level of medical decision making9695$0
99284Emergency department visit with moderate level of medical decision making4040$0
View full utilization report →

Insurance plans in this area (ZIP 66044)

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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: 1052730025View full group profile
NameSpecialtyState
Emergency MedicineKS
Nurse PractitionerKS
Emergency MedicineTX
Emergency MedicineKS
Emergency MedicineKS
Emergency MedicineKS
Emergency MedicineMI
Emergency MedicineKS
Emergency MedicineKS
Emergency MedicineKS

Reviews

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Frequently asked questions

What federal number belongs to DR. CHAD AMBROSE GUSTIN (M.D.)?
The federal identifier for DR. CHAD AMBROSE GUSTIN (M.D.) is NPI 1104086586.
Is DR. CHAD AMBROSE GUSTIN (M.D.)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What does DR. CHAD AMBROSE GUSTIN (M.D.) treat or focus on?
Patients typically see DR. CHAD AMBROSE GUSTIN (M.D.) under the specialty Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
What location metadata exists for DR. CHAD AMBROSE GUSTIN (M.D.)?
The page summarizes Lawrence, Kansas for DR. CHAD AMBROSE GUSTIN (M.D.); expand the address list for detail.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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