JOHN GUSTAVSSON (MD) – Diagnostic Radiology Physician, NPI 1437199254
Diagnostic Radiology Physician
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Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
532 DIAGNOSTIC RADIOLOGY in OR
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Provider Addresses for JOHN GUSTAVSSON (MD)
Flying Elephants Delicatessen, 2701, Northwest Vaughn Street, Northwest District, Portland, Metro, Multnomah County, Oregon, 97210, United States
STE 425
PORTLAND, OR 972105311
Phone: (503) 227-2400
Fax: (503) 227-0218
Type: Mailing
Legacy Emanuel Medical Center, 2801, North Gantenbein Avenue, Albina, Eliot, Portland, Metro, Multnomah County, Oregon, 97227, United States
PORTLAND, OR 972271623
Phone: (503) 413-4032
Fax: (503) 227-0218
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: 2004-05-25
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 |
|---|---|---|---|---|
| I20040525001355 | I | Diagnostic Radiology | OR | 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 |
|---|---|---|---|---|
| 71045 | X-ray of chest, 1 view | 246 | 211 | $0 |
| 70450 | Ct scan head or brain without contrast | 122 | 111 | $0 |
| 72125 | Ct scan of upper spine without contrast | 68 | 64 | $0 |
| 74177 | Ct scan of abdomen and pelvis with contrast | 66 | 66 | $0 |
| 71046 | X-ray of chest, 2 views | 45 | 45 | $0 |
Insurance plans in this area (ZIP 97210)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology | MN | |
| Diagnostic Radiology | OR | |
| - | OR | |
| - | OR | |
| Diagnostic Radiology | OR | |
| Diagnostic Radiology | WA | |
| Diagnostic Radiology | OR |
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