Mallory M Gustafson, ARNP - Medicare Nurse Practitioner in Deland, FL

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Mallory M Gustafson, ARNP is a medicare enrolled "Nurse Practitioner - Family" in Deland, Florida. Her current practice location is 632 E Victoria Trails Blvd, Deland, Florida. You can reach out to her office (for appointments etc.) via phone at (970) 443-0948.

Mallory M Gustafson is licensed to practice in Florida (license number ARNP9383627) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1144728486.

Contact Information

Mallory M Gustafson, ARNP
632 E Victoria Trails Blvd,
Deland, FL 32724-7911
(970) 443-0948
Not Available

Map and Direction




Provider's Profile

Full NameMallory M Gustafson
GenderFemale
SpecialityNurse Practitioner - Family
Location632 E Victoria Trails Blvd, Deland, Florida
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1144728486
  • Provider Enumeration Date: 01/31/2018
  • Last Update Date: 01/31/2018
  Medicare PECOS Information:
  • PECOS PAC ID: 0446514921
  • Enrollment ID: I20180509001387

Medical Identifiers

Medical identifiers for Mallory M Gustafson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1144728486NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family ARNP9383627 (Florida)Primary

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. Mallory M Gustafson allows following entities to bill medicare on her behalf.
Entity NameEmergency Physicians Of Central Florida Llp
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1326033341
PECOS PAC ID: 1850296567
Enrollment ID: O20031205000109
Entity NameLewis & Klancke Cardiology Pa
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1669589263
PECOS PAC ID: 6305731860
Enrollment ID: O20040216000513
Entity NameExcellence Health Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1447741749
PECOS PAC ID: 0840534160
Enrollment ID: O20181127002760

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. Mallory M 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
Mallory M Gustafson, ARNP
632 E Victoria Trails Blvd,
Deland, FL 32724-7911

Ph: (970) 443-0948		Mallory M Gustafson, ARNP
632 E Victoria Trails Blvd,
Deland, FL 32724-7911

Ph: (970) 443-0948

Reviews and Comments


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Deborah Vega Darnell, ARNP
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Phone: 386-740-7080    Fax: 386-734-0821
Dr. Mary Theresa Izzo, PHD, ARNP
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Mrs. Rachel Ellen Hart, NP-C
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Ms. Carmelia Maria Lee, NP
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Phone: 717-247-9054    

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.