MR. ANDREW GUSTAVSON (NPI# 1053826560) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053826560 |
| Entity Type | Individual |
| Full Name | MR. ANDREW GUSTAVSON |
| Credential | MA |
| Practice Address |
183 South Orange Avenue Floor D Newark NJ 07103 |
| Mailing Address |
671 Hoes Lane Piscataway NJ 08855 |
| Practice Telephone | 9739725479 |
| Enumeration Date | 2017-12-06 |
| Last Update Date | 2017-12-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538182118 | Andrew Roger Gustavson | Psychiatry & Neurology | 604 N Acadia Rd, Suite 411, Thibodaux, LA 70301-4897 | 2006-07-25 |
| Street Address |
183 SOUTH ORANGE AVENUE FLOOR D |
| City | NEWARK |
| State | NJ |
| Zip Code | 07103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588746507 | Margaret Kelly | Social Worker | 183 South Orange Avenue, Newark, NJ 07103 | 2006-10-19 |
| 1386130995 | Faisal Kagadkar | Student in an Organized Health Care Education/Training Program | 183 South Orange Avenue, Behavioral Health Science Building, Newark, NJ 07101 | 2018-07-06 |
| 1144736141 | Lara M Aunio | Counselor | 183 South Orange Avenue, Newark, NJ 07103 | 2017-12-28 |
| 1508265620 | Saba Afzal | Psychiatry & Neurology | 183 South Orange Avenue, Rutgers Bhsb, Newark, NJ 07101 | 2014-08-14 |
| 1023251964 | Rosanna Dejesus | Counselor | 183 South Orange Avenue, Newark, NJ 07103 | 2009-04-08 |
| 1851536288 | Robin Duckett | Counselor | 183 South Orange Avenue, Newark, NJ 07103 | 2008-12-15 |
| 1043475742 | Carmen T Colon | Counselor | 183 South Orange Avenue, Newark, NJ 08854 | 2008-07-22 |
| 1760646988 | Muhammad Abbass | Psychologist | 183 South Orange Avenue, Newark, NJ 07103 | 2008-07-16 |
| 1801057039 | William Tate | Counselor | 183 South Orange Avenue, Newark, NJ 07103 | 2008-06-20 |
| 1831362722 | Donald Bey | Registered Nurse | 183 South Orange Avenue, Newark, NJ 07103 | 2008-04-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124657077 | Yingna Liu | Student in an Organized Health Care Education/Training Program | Medical Science Building, 185 South Orange Avenue, Newark, NJ 07103 | 2020-04-03 |
| 1568029684 | Martins Akhibi | Nurse Practitioner | 178 Newton Street, Newark, NJ 07103 | 2019-05-23 |
| 1972168482 | Newark Renaissance House, Inc | Rehabilitation, Substance Use Disorder Unit | 50-56 Norfolk Street, Newark, NJ 07103 | 2019-05-09 |
| 1346709235 | Ian Wang Yu | Student in an Organized Health Care Education/Training Program | 185 South Orange Ave., Medical Science Building, Room I-506, Newark, NJ 07103 | 2019-03-19 |
| 1437648417 | Stephen Vanbeek | Internal Medicine | 185 S Orange Ave Rm 547, Newark, NJ 07103 | 2018-05-06 |
| 1073019444 | Geoffrey Alexander Talis | Student in an Organized Health Care Education/Training Program | 183 S. Orange Avenue, Level E, Room 1452, Newark, NJ 07103 | 2018-04-03 |
| 1285139907 | Thomas Georg Bachmann | Student in an Organized Health Care Education/Training Program | 185 South Orange Ave, Medical Science Building, G-538, Newark, NJ 07103 | 2018-03-26 |
| 1154825289 | Shammi A Patel | Student in an Organized Health Care Education/Training Program | 185 S Orange Ave # Msbg594, Newark, NJ 07103 | 2018-03-22 |
| 1982122545 | North Jersey Aids Alliance | Clinic/Center | 393 Central Avenue C/o Corey Destefano, Newark, NJ 07103 | 2017-09-05 |
| 1134655533 | Yasmin N Abedin | Student in an Organized Health Care Education/Training Program | 185 South Orange Ave, Msb E-506, Rutgers, New Jersey Medical School, Newark, NJ 07103 | 2017-05-04 |
| Find all providers in zip 07103 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982223897 | Verne Taylor | Case Manager/Care Coordinator | 36397 Dijon Dr, Newark, CA 94560-2458 | 2020-04-10 |
| 1669006698 | Kennedy Asa Smith | Case Manager/Care Coordinator | 15 N 3rd St # 200, Newark, OH 43055-5550 | 2020-02-28 |
| 1942848403 | Amia J Pinckney | Case Manager/Care Coordinator | 243 South 11th Street, Newark, NJ 07103-0710 | 2019-12-16 |
| 1770125585 | Jessica Danielle Dunkle | Case Manager/Care Coordinator | 15 N 3rd Street Suite 300, Newark, OH 43055 | 2019-10-14 |
| 1730735473 | Valllery Supplice | Case Manager/Care Coordinator | 218 Sherman Ave, Newark, NJ 07114-1650 | 2019-08-16 |
| 1497233084 | Leighanna Wagner | Case Manager/Care Coordinator | 1547 Crystal Ct Apt D, Newark, OH 43055-6184 | 2018-08-06 |
| 1689192817 | Melanie Swarthout | Case Manager/Care Coordinator | 150 Van Buren St., Newark, NY 14513 | 2017-09-08 |
| 1154857779 | Julian King | Case Manager/Care Coordinator | 2590 Loper Rd Ne, Newark, OH 43055-9728 | 2017-05-02 |
| 1548617103 | Jose Andres Morales | Case Manager/Care Coordinator | 541 Roseville Av., Newark, NJ 07107 | 2016-05-24 |
| 1619324563 | Juliana N Dasilva | Case Manager/Care Coordinator | 59 Wilson Ave, #3, Newark, NJ 07105-3216 | 2016-05-20 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.