Tesha Gustafson, OD is a medicare enrolled "Optometrist" provider in Kenmare, North Dakota. She went to Pacific University - College Of Optometry and graduated in 2016 and has 10 years of diverse experience with area of expertise as Optometry. Her current practice location is
28 2nd St Nw, Kenmare, North Dakota. You can reach out to her office (for appointments etc.) via phone at
(701) 385-4004.
Tesha Gustafson is licensed to practice in North Dakota (license number 745) 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 1467807230.
Healthcare Provider's Profile
| Full Name | Tesha Gustafson |
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| Gender | Female |
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| Speciality | Optometry |
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| Experience | 10 Years |
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| Location | 28 2nd St Nw, Kenmare, North Dakota |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Tesha Gustafson attended and graduated from Pacific University - College Of Optometry in 2016
NPI Data:
- NPI Number: 1467807230
- Provider Enumeration Date: 04/29/2016
- Last Update Date: 02/04/2019
Medicare PECOS Information:
- PECOS PAC ID: 5597053207
- Enrollment ID: I20161012002891
Medical Identifiers
Medical identifiers for Tesha Gustafson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1467807230 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 152W00000X | Optometrist | 745 (North Dakota) | 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. Tesha Gustafson allows following entities to bill medicare on her behalf.
| Provider Name | Optometry Clinic, Pc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1225686827
PECOS PAC ID: 5193158947
Enrollment ID: O20191209001363 |
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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. Tesha 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 Address | Practice Location Address |
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Tesha Gustafson, OD
28 2nd St Nw,
Kenmare, ND 58746-7114
Ph: (701) 385-4004 | Tesha Gustafson, OD
28 2nd St Nw,
Kenmare, ND 58746-7114
Ph: (701) 385-4004 |
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