Dr Jacqueline Jeanette Carter Gustafson, MD - Medicare General Surgery in Cleveland, TN

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Dr Jacqueline Jeanette Carter Gustafson, MD is a medicare enrolled "Surgery" physician in Cleveland, Tennessee. She went to Loma Linda University School Of Medicine and graduated in 2005 and has 20 years of diverse experience with area of expertise as General Surgery. She is a member of the group practice Privia Medical Group Tennessee Llc, Tennessee Oncology Pllc and her current practice location is 2700 Westside Dr Nw Ste 204, Cleveland, Tennessee. You can reach out to her office (for appointments etc.) via phone at (423) 244-9270.

Dr Jacqueline Jeanette Carter Gustafson is licensed to practice in Tennessee (license number MD67660) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1023209632.

Contact Information

Dr Jacqueline Jeanette Carter Gustafson, MD
2700 Westside Dr Nw Ste 204,
Cleveland, TN 37312-3682
(423) 244-9270
(423) 244-9255

Map and Direction




Physician's Profile

Full NameDr Jacqueline Jeanette Carter Gustafson
GenderFemale
SpecialityGeneral Surgery
Experience20 Years
Location2700 Westside Dr Nw Ste 204, Cleveland, Tennessee
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dr Jacqueline Jeanette Carter Gustafson attended and graduated from Loma Linda University School Of Medicine in 2005
  NPI Data:
  • NPI Number: 1023209632
  • Provider Enumeration Date: 08/08/2007
  • Last Update Date: 08/20/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 1456522499
  • Enrollment ID: I20241031002403

Medical Identifiers

Medical identifiers for Dr Jacqueline Jeanette Carter Gustafson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1023209632NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208600000XSurgery MD67660 (Tennessee)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Tristar Stonecrest Medical CenterSmyrna, TNHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Privia Medical Group Tennessee Llc054766755296
Tennessee Oncology Pllc4688586134323

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. Dr Jacqueline Jeanette Carter Gustafson allows following entities to bill medicare on her behalf.
Entity NameTennessee Oncology Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1811955917
PECOS PAC ID: 4688586134
Enrollment ID: O20031103000534
Entity NameThe Surgical Clinic Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1417983099
PECOS PAC ID: 1759271695
Enrollment ID: O20040316000974
Entity NamePrivia Medical Group Tennessee Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1376110858
PECOS PAC ID: 0547667552
Enrollment ID: O20210917001131

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. Dr Jacqueline Jeanette Carter 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
Dr Jacqueline Jeanette Carter Gustafson, MD
2700 Westside Dr Nw Ste 204,
Cleveland, TN 37312-3682

Ph: (423) 244-9270		Dr Jacqueline Jeanette Carter Gustafson, MD
2700 Westside Dr Nw Ste 204,
Cleveland, TN 37312-3682

Ph: (423) 244-9270

Reviews and Comments


Surgery Doctors in Cleveland, TN

Joshua Worthington, MD
Surgery
Medicare: Accepting Medicare Assignments
Practice Location: 2175 Chambliss Ave Nw Ste D, Cleveland, TN 37311
Phone: 423-472-5423    Fax: 423-476-5523
William Frank Johnson Ii, MD
Surgery
Medicare: Not Enrolled in Medicare
Practice Location: 2253 Chambliss Ave Nw, Suite 100, Cleveland, TN 37311
Phone: 423-472-5423    Fax: 423-476-5523
Shannon Beierle, MD
Surgery
Medicare: Accepting Medicare Assignments
Practice Location: 2175 Chambliss Ave Nw Ste D, Cleveland, TN 37311
Phone: 423-472-5423    Fax: 423-476-5523
John Boxberger, MD
Surgery
Medicare: Accepting Medicare Assignments
Practice Location: 2175 Chambliss Ave Nw Ste D, Cleveland, TN 37311
Phone: 423-472-5423    Fax: 423-476-5523
James L Knabb, MD
Surgery
Medicare: Medicare Enrolled
Practice Location: 2301 N Ocoee Street, Suite B, Cleveland, TN 37311
Phone: 423-479-9647    Fax: 423-479-2216
Eugene D. Eddlemon, M.D.
Surgery
Medicare: Accepting Medicare Assignments
Practice Location: 2253 Chambliss Ave., Ste. 401, Cleveland, TN 37311
Phone: 423-267-0466    Fax: 423-778-5177

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.