ERIK GUSTAVSON (OD) – Optometrist, NPI 1053137505

ERIK GUSTAVSON (OD) is a healthcare provider. based in Albany, Oregon. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. AT4755 (OR). The NPI Number for ERIK GUSTAVSON (OD) is 1053137505

Main info

Male
3 Years Of Experience
Accepts Medicare Assignment
Name
ERIK GUSTAVSON (OD)
NPI
1053137505
Phone
(541) 223-0179
Address
1801 14th Ave SE
Enumeration Date
2 December 2024
Last Update Date
20 February 2026

Doctor Profile

Medical School Name
ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
Secondary Phone
5414849999
Graduation Year
2023 (3 years ago)
PAC ID
1850885849
Group Practice PAC ID
6406843598
Professional Enrollment ID
I20251208002244
Address ID
OR974014805EU2540XRDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness85
Years active:1State licenses:1Digital endpointsOther names

672 OPTOMETRY in OR

Provider Addresses for ERIK GUSTAVSON (OD)

  • 1801 14th Ave SE

    Albany, OR 973228502

    Phone: (541) 223-0179

    Type: Location

  • 2540 WILLAKENZIE RD

    EUGENE, OR 974014805

    Phone: (541) 484-9999

    Fax: (541) 484-0616

    Type: Mailing

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: 2025-12-08

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
I20251208002244IOptometryORTBD

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 97322)

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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: 6406843598View full group profile

Reviews

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Frequently asked questions

Does ERIK GUSTAVSON (OD) have a public NPI I can cite?
Public records show ERIK GUSTAVSON (OD) under NPI 1053137505.
Is ERIK GUSTAVSON (OD)'s NPI status active today?
Active status means ERIK GUSTAVSON (OD)'s NPI record is not deactivated in the public file.
What type of care does ERIK GUSTAVSON (OD) provide?
ERIK GUSTAVSON (OD)'s profile centers on Optometrist. Clinical services aligned with this taxonomy classification.
Is ERIK GUSTAVSON (OD) tied to Albany, Oregon?
If you are local to Albany, Oregon, ERIK GUSTAVSON (OD) may be relevant to your search.
Why is information missing for ERIK GUSTAVSON (OD)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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