Evan Gustavsen, PT, DPT
NPI 1932754496ActiveIndividual· Physical Therapist· Boise, ID
Physical Therapist (PT, DPT) with Physical Therapy at Thrive, LLC and 1 other group, practicing in Boise, Idaho. Medicare paid $34,629 for services to 51 patients in 2024.
Overview
| NPI | 1932754496 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PT, DPT |
| Sole proprietor | No |
| NPI issued | Aug 1, 2019 |
| Last updated in NPPES | Apr 9, 2026 |
| Certified by provider | Apr 9, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 6426 | ID |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physical Therapist in Private Practice (ID) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 51 |
|---|---|
| Services billed | 1,768 across 8 procedure codes |
| Paid by Medicare | $34,629 |
Education and affiliations
| Graduation year | 2019 |
|---|---|
| Medicare specialty | Physical Therapist In Private Practice |
Medical groups
- Physical Therapy at Thrive, LLCBoise, ID · 6 clinicians
- Physical Therapy 180 LLCBoise, ID · 3 clinicians
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All 474 physical therapists in Boise · All physical therapists in Idaho