L Mark Gustafson, MD - Medicare Otolaryngology in Carrollton, GA

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L Mark Gustafson, MD is a medicare enrolled "Otolaryngology" physician in Carrollton, Georgia. He graduated from medical school in 1996 and has 28 years of diverse experience with area of expertise as Otolaryngology. He is a member of the group practice Tanner Medical Group and his current practice location is 150 Clinic Ave, Suite 201, Carrollton, Georgia. You can reach out to his office (for appointments etc.) via phone at (770) 832-1488.

L Mark Gustafson is licensed to practice in Georgia (license number 049795) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1073555629.

Contact Information

L Mark Gustafson, MD
150 Clinic Ave, Suite 201,
Carrollton, GA 30117-4401
(770) 832-1488
Not Available

Map and Direction




Physician's Profile

Full NameL Mark Gustafson
GenderMale
SpecialityOtolaryngology
Experience28 Years
Location150 Clinic Ave, Carrollton, Georgia
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • L Mark Gustafson graduated from medical school in 1996
  NPI Data:
  • NPI Number: 1073555629
  • Provider Enumeration Date: 06/11/2006
  • Last Update Date: 07/18/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 5092885079
  • Enrollment ID: I20080603000158

Medical Identifiers

Medical identifiers for L Mark Gustafson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1073555629NPI-NPPES
841043OtherGABLUE CROSS CLUE SHIELD
00906463CMedicaidGA
00906463BMedicaidGA

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Y00000XOtolaryngology 049795 (Georgia)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Tanner Medical Center - CarrolltonCarrollton, GAHospital
Tanner Medical Center Villa RicaVilla rica, GAHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Tanner Medical Group276953614398

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. L Mark Gustafson allows following entities to bill medicare on his behalf.
Entity NameCarrollton Ear Nose And Throat Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1760410401
PECOS PAC ID: 3577558931
Enrollment ID: O20040416000289
Entity NameTanner Medical Group Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1396979787
PECOS PAC ID: 2769536143
Enrollment ID: O20090819000657

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. L Mark Gustafson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
L Mark Gustafson, MD
150 Clinic Ave, Suite 201,
Carrollton, GA 30117-4401

Ph: (770) 832-1488		L Mark Gustafson, MD
150 Clinic Ave, Suite 201,
Carrollton, GA 30117-4401

Ph: (770) 832-1488

Reviews and Comments


Otolaryngology Doctors in Carrollton, GA

Dr. William Bradley Gambrell, M.D.
Otolaryngology
Medicare: Accepting Medicare Assignments
Practice Location: 150 Clinic Ave, Suite 201, Carrollton, GA 30117
Phone: 770-832-1488    
John C Pezold, M.D.
Otolaryngology
Medicare: Accepting Medicare Assignments
Practice Location: 150 Clinic Ave, Suite 201, Carrollton, GA 30117
Phone: 770-832-1488    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.