Active NPI 1164492096 Individual Practitioner Male Practitioner

Dr. Thomas Earl Gustafson , OD

Optometrist • Palatine, IL

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Thomas Gustafson, OD is a certified Optometrist practicing in Palatine, IL. With approximately 37 years of clinical experience since graduating from Ferris State College - College Of Optometry in 1989, Dr. Gustafson delivers high-quality medical care to the local community at 96 W NORTHWEST HWY.

Dr. Gustafson is affiliated with Gustafson Eye Care Clinics, Ltd. and accepts Medicare assignment.

Frequently performed procedures and clinical services include removal of cataract with insertion of lens, established patient outpatient office visit, photography of the retina. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

96 W Northwest Hwy

Palatine, IL 600673571

Telephone 8473587722

Fax 8479340661

Associated Practice Facility / Clinic

🏢 Gustafson Eye Care Clinics, Ltd. Facility NPI 1215138771

Medicare Profile & Education

Medical School

Ferris State College - College Of Optometry

Graduation Year

1989

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Palatine, IL

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

37 Yrs +9.2 yrs vs City Avg

City Avg: 27.8 Yrs

State Avg: 22.8 Yrs

Regional Practice Density

10 Specialists

Practicing in Palatine, IL (2783 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

34.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Gustafson (37 Years) 37 Yrs

Palatine Specialty Average (27.8 Years) 27.8 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
66984 Removal of cataract with insertion of lens	1,531	16	$2.59	$1.30
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	309	297	$180.06	$132.61
92250 Photography of the retina	304	301	$80.00	$37.63
99213 Established patient office or other outpatient visit, typically 15 minutes	170	136	$124.00	$94.03
92134 Imaging of retina	63	62	$90.00	$40.81
92014 Established patient complete exam of visual system	63	63	$167.57	$126.47
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	45	45	$180.00	$99.74
92133 Imaging of optic nerve	45	44	$90.00	$34.09
92083 Exam of visual field with extended testing	43	42	$100.00	$64.01
92020 Examination of cornea and iris using lens device and slit lamp	37	36	$46.00	$27.60
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	27	27	$199.00	$174.95
76514 Ultrasound scan of cornea to determine thickness	15	15	$28.00	$11.18

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	304	294	$180.06	$133.66
92250 Photography of the retina	282	280	$80.00	$38.57
99213 Established patient office or other outpatient visit, typically 15 minutes	152	115	$124.00	$94.52
92134 Imaging of retina	51	48	$90.00	$41.50
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	37	37	$180.00	$101.92
92083 Exam of visual field with extended testing	30	28	$100.00	$64.36
92133 Imaging of optic nerve	29	29	$90.00	$35.45
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	28	28	$199.00	$175.45
92014 Established patient complete exam of visual system	21	21	$159.00	$129.29
92020 Examination of cornea and iris using lens device and slit lamp	16	16	$46.00	$28.31

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
66984 Removal of cataract with insertion of lens	1,353	13	$2.93	$1.52
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	265	257	$180.13	$135.45
92250 Photography of the retina	234	232	$80.00	$39.09
99213 Established patient office or other outpatient visit, typically 15 minutes	94	76	$116.26	$92.37
92014 Established patient complete exam of visual system	50	50	$159.00	$132.38
92134 Imaging of retina	33	31	$90.00	$42.56
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	27	27	$199.00	$179.06
92083 Exam of visual field with extended testing	24	21	$100.00	$65.77
92133 Imaging of optic nerve	17	17	$90.00	$35.60
92012 Established patient problem focused exam of visual system	12	11	$120.00	$94.69

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
66984 Removal of cataract with insertion of lens	1,980	15	$2.48	$1.29
92014 Established patient complete exam of visual system	379	375	$159.00	$133.86
92250 Photography of the retina	253	253	$79.76	$41.54
92012 Established patient problem focused exam of visual system	141	112	$120.00	$95.17
92134 Imaging of retina	44	44	$90.00	$43.41
92004 New patient complete exam of visual system	25	25	$156.00	$156.00
92083 Exam of visual field with extended testing	24	21	$100.00	$67.03
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	22	22	$180.00	$180.00
92133 Imaging of optic nerve	18	18	$90.00	$36.31
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	15	15	$180.00	$138.80

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	284	282	$149.28	$132.92
92250 Photography of the retina	202	201	$79.70	$47.56
92012 Established patient problem focused exam of visual system	139	119	$120.00	$93.08
92134 Imaging of retina	49	48	$90.00	$42.92
92004 New patient complete exam of visual system	42	42	$151.64	$151.32
92083 Exam of visual field with extended testing	32	31	$100.00	$66.62
92133 Imaging of optic nerve	29	29	$90.00	$36.69
92020 Examination of cornea and iris using lens device and slit lamp	14	14	$46.00	$29.09
99213 Established patient office or other outpatient visit, typically 15 minutes	14	12	$80.00	$79.64
76514 Ultrasound scan of cornea to determine thickness	11	11	$28.00	$12.30

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
66984 Removal of cataract with insertion of lens	1,890	11	$2.22	$1.51
92014 Established patient complete exam of visual system	424	421	$144.00	$131.57
92250 Photography of the retina	242	242	$80.00	$52.57
92012 Established patient problem focused exam of visual system	170	143	$119.74	$91.94
92134 Imaging of retina	64	63	$90.00	$42.74
92004 New patient complete exam of visual system	46	46	$155.74	$153.89
92083 Exam of visual field with extended testing	32	30	$100.00	$66.62
92133 Imaging of optic nerve	29	28	$90.00	$36.13
99213 Established patient office or other outpatient visit, typically 15 minutes	18	14	$79.33	$77.57
92020 Examination of cornea and iris using lens device and slit lamp	12	12	$46.00	$28.59
76514 Ultrasound scan of cornea to determine thickness	11	11	$28.00	$12.70

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	353	346	$144.00	$124.29
92250 Photography of the retina	190	185	$80.00	$56.32
92012 Established patient problem focused exam of visual system	137	115	$113.60	$86.36
92004 New patient complete exam of visual system	78	78	$156.00	$148.49
92134 Imaging of retina	53	50	$90.00	$40.89
92083 Exam of visual field with extended testing	29	26	$100.00	$63.27
99213 Established patient office or other outpatient visit, typically 15 minutes	23	21	$78.96	$72.32
92133 Imaging of optic nerve	20	19	$90.00	$34.65

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
66984 Removal of cataract with insertion of lens	1,438	13	$2.23	$1.41
92014 Established patient complete exam of visual system	314	309	$144.00	$120.40
92250 Photography of the retina	176	176	$80.00	$64.13
92012 Established patient problem focused exam of visual system	133	100	$99.21	$83.45
92004 New patient complete exam of visual system	51	51	$155.76	$145.46
92134 Imaging of retina	50	43	$90.00	$40.01
92083 Exam of visual field with extended testing	32	22	$100.00	$62.18
92133 Imaging of optic nerve	18	17	$90.00	$34.88
99213 Established patient office or other outpatient visit, typically 15 minutes	14	13	$75.71	$70.06

Medical Specialties & State Licenses

CMS Verified: 2020-03-13

Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License IL 046008241

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

046008241 (IL)

Hospital & Practice Group Affiliations

Gustafson Eye Care Clinics, Ltd.

96 W Northwest Hwy, Palatine, IL 600673571

Phone: 8473587722

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

12 Historical Events

📍

Updated Business Mailing Address March 13, 2020

Registered at 96 W NORTHWEST HWY, PALATINE, IL 600673571 (Tel: 8473587722)

✅

NPI Profile Active January 26, 2018

NPI status registered as active in NPPES database

📍

Updated Practice Location January 26, 2018

Registered at 96 W NORTHWEST HWY, PALATINE, IL 600673571 (Tel: 8473587722)

📍

Updated Business Mailing Address January 26, 2018

Registered at 620 N OLD RAND RD, LAKE ZURICH, IL 600472208 (Tel: 8475407308)

👤

Provider Name / Credentials Updated January 26, 2018

Recorded as THOMAS GUSTAFSON, O.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) January 26, 2018

Optometrist (License #046008241 in IL)

✅

NPI Profile Active February 18, 2013

NPI status registered as active in NPPES database

📍

Updated Practice Location February 18, 2013

Registered at 96 W NORTHWEST HWY, PALATINE, IL 600673571 (Tel: 8473587722)

📍

Updated Business Mailing Address February 18, 2013

Registered at 620 N OLD RAND RD, LAKE ZURICH, IL 600472208 (Tel: 8475407308)

👤

Provider Name / Credentials Updated February 18, 2013

Recorded as THOMAS GUSTAFSON, O.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) February 18, 2013

Optometrist (License #046008241 in IL)

🟢

Initial NPI Registration & Enumeration January 24, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews

No patient reviews submitted yet for Dr. Thomas Gustafson. Be the first to share your experience!

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1164492096

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: January 24, 2006

Last Update: March 13, 2020

Sole Proprietor: No

Update or Correct Profile

Mailing Address

96 W Northwest Hwy

Palatine, IL 600673571

Phone: 8473587722

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.