DR. MICHAEL J GUSTAVEL (NPI# 1306842182) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306842182 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL J GUSTAVEL |
| Credential | MD |
| Practice Address |
1702 W Fairview Ave Boise ID 83702-5121 |
| Mailing Address |
1188 W University Dr Boise ID 83706-3009 |
| Practice Telephone | 2088501641 |
| Mailing Telephone | 2083368250 |
| Mailing Fax Number | 2083459514 |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2019-02-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
M8510 | ID | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 1306842182 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1188 University Dr, Boise, ID 83706 | 2083368250 | 2083459514 |
| 1702 W Fairview Ave, Boise, ID 837025121 | 2088501641 |
| Street Address |
1702 W FAIRVIEW AVE |
| City | BOISE |
| State | ID |
| Zip Code | 83702-5121 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861961732 | Gustavel Orthopedics Pllc | Orthopaedic Surgery | 1702 W Fairview Ave, Boise, ID 83702-5121 | 2018-11-20 |
| 1811002900 | Maryann Ozier | Physician Assistant | 1702 W Fairview Ave, Boise, ID 83702-5121 | 2006-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790321966 | Inland Northwest Neuromonitoring Pllc | Psychiatry & Neurology | 950 Bannock Street, Suite 1100, Boise, ID 83702 | 2019-11-22 |
| 1508359084 | Emily Cook | Dietitian, Registered | St. Luke's Rehab Hospital, 600 N Robbins Road, Bosie, ID 83702 | 2018-06-11 |
| 1265925887 | Marla Braendle | Dietitian, Registered | St. Luke's Rehabilitation Hospital, 600 N. Robbins Road, Boise, ID 83702 | 2018-06-08 |
| 1114419678 | Sidrah Khan Psychotherapy PC | Social Worker | 242 N 8th St, Suite 200, Boise, ID 83702 | 2018-05-31 |
| 1508386707 | Emp Idaho Nampa, LLC | General Acute Care Hospital | 350 E Myrtle Street, Suite 100, Boise, ID 83702 | 2017-06-20 |
| 1194264077 | Karen Mangum | Dietitian, Registered | 115 N. Main Street, Suite #203, Boise, ID 83702 | 2017-02-13 |
| 1750828422 | Stephen Pyper | Massage Therapist | 14089 Main St #100, Boise, ID 83702 | 2017-01-19 |
| 1427504398 | The Young Mens Christian Association of Boise City Idaho | Health Educator | 419 N 11th St, Boise, ID 83702 | 2016-08-30 |
| 1942756838 | Brent Hiroshi Sasaki | Pharmacist | 500 West Fort Street (119), Boise, ID 83702 | 2016-08-30 |
| 1578912051 | Marnae Walker | Counselor | 509 S. 14th St, Suite 2, Boise, ID 83702 | 2016-06-06 |
| Find all providers in zip 83702 | ||||
| Taxonomy Code | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063418903 | George A. Wade | Orthopaedic Surgery | 1188 University Dr, Boise, ID 83706-3009 | 2005-06-24 |
| 1861961732 | Gustavel Orthopedics Pllc | Orthopaedic Surgery | 1702 W Fairview Ave, Boise, ID 83702-5121 | 2018-11-20 |
| 1780694182 | Erik J Heggland | Orthopaedic Surgery | 1109 W Myrtle St, Suite 200, Boise, ID 83702-6970 | 2006-08-08 |
| 1245236983 | Jennifer Rawlings Miller | Orthopaedic Surgery | 1188 University Dr, Boise, ID 83706 | 2005-06-27 |
| 1033115803 | Kirk J Lewis | Orthopaedic Surgery | 1188 University Dr, Boise, ID 83706 | 2005-06-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790399517 | Delaney Bergen | Orthopaedic Surgery | 738 N College Rd Ste C, Twin Falls, ID 83301-3387 | 2020-08-31 |
| 1164597431 | Douglas Alan Cipriano | Orthopaedic Surgery | 606 N. 3rd Avenue, Suite 201, Sandpoint, ID 83864-1689 | 2006-11-22 |
| 1558375568 | Joseph R Liljenquist | Orthopaedic Surgery | 3405 Merlin Drive, Idaho Falls, ID 83404 | 2006-07-27 |
| 1124061163 | Sun Valley Sports Medicine, P.a. | Orthopaedic Surgery | 191 5th St W, Ketchum, ID 83340 | 2006-06-14 |
| 1568443158 | Paul Calvin Collins | Orthopaedic Surgery | 3875 E Overland Rd, Meridian, ID 83642-9005 | 2005-11-10 |
| 1114445087 | Bmh Inc. | Orthopaedic Surgery | 560 Memorial Dr, Pocatello, ID 83201-4070 | 2017-08-31 |
| 1982060984 | Bonner General Hospital, Inc | Orthopaedic Surgery | 606 N 3rd Ave, Ste 201, Sandpoint, ID 83864-1594 | 2016-01-06 |
| 1477965952 | Gregory M. Ford, Md Pllc | Orthopaedic Surgery | 950 Hospital Way, Ste A, Pocatello, ID 83201-2789 | 2014-06-02 |
| 1932532686 | Jason P Richards Md Pllc | Orthopaedic Surgery | 444 Hospital Way Ste 477, Pocatello, ID 83201-2744 | 2013-08-16 |
| 1013264183 | Teton Valley Health Care Inc | Orthopaedic Surgery | 283 N 1st E, Driggs, ID 83422-5109 | 2012-08-08 |
| Find all providers with the same taxonomy | ||||
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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.