L Mark Gustafson, M.D.
NPI 1073555629ActiveIndividual· Otolaryngology· Carrollton, GA
Otolaryngology (M.D.) with Tanner Medical Group Inc, practicing in Carrollton, Georgia. 433 Medicare patients in 2024, $63,520 paid; nearly all of their 2,002 Part D prescriptions were generic (97%). Davol Inc. reported $47.56 in payments in 2024, mostly food and beverage. Lists Tanner Medical Center - Carrollton as a hospital affiliation.
Overview
| NPI | 1073555629 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | M.D. |
| Sole proprietor | No |
| NPI issued | Jun 11, 2006 |
| Last updated in NPPES | Jul 18, 2022 |
| Certified by provider | Jul 18, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Otolaryngology Primary | 207Y00000X | 049795 | GA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Otolaryngology (GA) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 433 |
|---|---|
| Services billed | 5,333 across 48 procedure codes |
| Paid by Medicare | $63,520 |
Part D prescriptions in 2024
| Prescriptions (claims) | 2,002 · 2,673 30-day fills |
|---|---|
| Patients | 608 |
| Total drug cost | $39,700 |
| Generic share | 97% of claims |
Education and affiliations
| Graduation year | 1996 |
|---|---|
| Medicare specialty | Otolaryngology |
Medical group
- Tanner Medical Group IncBremen, GA · 122 clinicians
Hospital affiliation
- Tanner Medical Center - CarrolltonCarrollton, GA
Industry payments (Open Payments)
- 2024$47.56 · 1 payment from 1 company
Top paying companies in 2024
| Company | Amount | Payments |
|---|---|---|
| Davol Inc. | $47.56 | 1 |
What the 2024 payments were for
- Food and Beverage$47.56 · 1 payment
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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