NICHOLAS GUSTAFSON – Hematology & Oncology Physician, NPI 1508286386
Hematology & Oncology Physician
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
727 HEMATOLOGY/ONCOLOGY in IL
Provider Addresses for NICHOLAS GUSTAFSON
N66W33688 PRAIRIEVIEW LN
OCONOMOWOC, WI 530661938
Phone: (262) 719-2874
Type: Mailing
20201 CRAWFORD AVE
OLYMPIA FIELDS, IL 60461
Phone: (708) 747-4000
Type: Location
PO BOX 735044
CHICAGO, IL 606735044
Phone:
Type: Mailing
1222 N 23RD ST
SHEBOYGAN, WI 530813171
Phone: (920) 457-6800
Type: Location
3301 W FOREST HOME AVE
MILWAUKEE, WI 532152843
Phone:
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: 2020-12-29
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 |
|---|---|---|---|---|
| I20201229000344 | I | Hematology/Oncology | WI | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 460 | 219 | $0 |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 221 | 77 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 91 | 74 | $0 |
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 41 | 41 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 21 | 21 | $0 |
Insurance plans in this area (ZIP 53066)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Hematology/Oncology, Hospice/Palliative Care | WI | |
| - | WI | |
| Hospice/Palliative Care, Hematology/Oncology | IL |
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